Provider Demographics
NPI:1275864407
Name:GOEN, SUZANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:GOEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2691 COUNTY ROAD 1020
Mailing Address - Street 2:
Mailing Address - City:LAMPASAS
Mailing Address - State:TX
Mailing Address - Zip Code:76550-3487
Mailing Address - Country:US
Mailing Address - Phone:512-525-1151
Mailing Address - Fax:
Practice Address - Street 1:1007 W HIGHWAY 190 STE B
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-3886
Practice Address - Country:US
Practice Address - Phone:254-542-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional