Provider Demographics
NPI:1316034986
Name:CARLEY, SUZANNE L (MDIV LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:L
Last Name:CARLEY
Suffix:
Gender:F
Credentials:MDIV LMFT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2 OLD NEW MILFORD ROAD
Mailing Address - Street 2:LANDMARK OFFICE BUILDING SUITE 2A
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2426
Mailing Address - Country:US
Mailing Address - Phone:203-775-3282
Mailing Address - Fax:203-775-3478
Practice Address - Street 1:2 OLD NEW MILFORD ROAD
Practice Address - Street 2:SUITE 2A CHRISTIAN COUNSELING CENTER OF GREATER DANBURY
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2426
Practice Address - Country:US
Practice Address - Phone:203-775-3282
Practice Address - Fax:203-775-3282
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001023106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410001023CT01OtherANTHEM
P3535391OtherOXFORD
347674OtherMHN