Provider Demographics
NPI:1265648182
Name:WEEKS, SUSAN WHEELER (EDD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:WHEELER
Last Name:WEEKS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 ROUTE 146
Mailing Address - Street 2:PO BOX 92
Mailing Address - City:GUILDERLAND CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:12085
Mailing Address - Country:US
Mailing Address - Phone:518-861-6335
Mailing Address - Fax:
Practice Address - Street 1:40 N MAIN AVE
Practice Address - Street 2:COUNSELING FOR LAITY
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1481
Practice Address - Country:US
Practice Address - Phone:518-453-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health