Provider Demographics
NPI:1386651610
Name:LEHFELDT, SUSAN D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:D
Last Name:LEHFELDT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:D
Other - Last Name:BILITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:W175N11120 STONEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-6511
Mailing Address - Country:US
Mailing Address - Phone:262-345-5560
Mailing Address - Fax:262-345-5531
Practice Address - Street 1:17100 W NORTH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4436
Practice Address - Country:US
Practice Address - Phone:262-345-5560
Practice Address - Fax:262-345-5531
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2955-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43576900Medicaid