Provider Demographics
NPI:1306181045
Name:STENDEL, SUSAN LYNN (LLPC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNN
Last Name:STENDEL
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 S AIRPORT RD W UNIT C
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4718
Mailing Address - Country:US
Mailing Address - Phone:231-642-4642
Mailing Address - Fax:
Practice Address - Street 1:527 COBB ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2540
Practice Address - Country:US
Practice Address - Phone:231-775-3463
Practice Address - Fax:231-775-1692
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009767101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor