Provider Demographics
NPI:1275207730
Name:SUTTON, SUSAN ELIZABETH (LPC,NCC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:SUTTON
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 1:101 S ALLUMBAUGH WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-5658
Mailing Address - Country:US
Mailing Address - Phone:208-323-8888
Mailing Address - Fax:208-323-8889
Practice Address - Street 1:101 S ALLUMBAUGH WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-5658
Practice Address - Country:US
Practice Address - Phone:208-323-8888
Practice Address - Fax:208-323-8889
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-8214101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health