Provider Demographics
NPI:1225803596
Name:KASSAY, SUZANNAH MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:SUZANNAH
Middle Name:MARIE
Last Name:KASSAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 TSCHACHE LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-7965
Mailing Address - Country:US
Mailing Address - Phone:406-585-1360
Mailing Address - Fax:406-585-4650
Practice Address - Street 1:1695 TSCHACHE LN
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-7965
Practice Address - Country:US
Practice Address - Phone:406-585-1360
Practice Address - Fax:406-585-4650
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT65977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health