Provider Demographics
NPI:1245565282
Name:CHABOT, SUZANNE RENEE (LMFT, RN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:RENEE
Last Name:CHABOT
Suffix:
Gender:F
Credentials:LMFT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 STATE ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NY
Mailing Address - Zip Code:13323-3435
Mailing Address - Country:US
Mailing Address - Phone:315-525-3035
Mailing Address - Fax:
Practice Address - Street 1:7325 STATE ROUTE 5
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-3435
Practice Address - Country:US
Practice Address - Phone:315-859-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY578802-1163W00000X
NY000967106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163W00000XNursing Service ProvidersRegistered Nurse