Provider Demographics
NPI:1194824987
Name:LAUTEMANN, SUSAN STYLES (LPC,NCC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:STYLES
Last Name:LAUTEMANN
Suffix:
Gender:F
Credentials:LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 W END BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-1120
Mailing Address - Country:US
Mailing Address - Phone:336-750-0706
Mailing Address - Fax:
Practice Address - Street 1:453 W END BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-1120
Practice Address - Country:US
Practice Address - Phone:336-750-0706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC824101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health