Provider Demographics
NPI:1417284902
Name:WALKER, SUZANNE SCHULZE (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:SCHULZE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SHERWOOD TER STE W
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2232
Mailing Address - Country:US
Mailing Address - Phone:847-615-5450
Mailing Address - Fax:847-615-1783
Practice Address - Street 1:51 SHERWOOD TER STE W
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2232
Practice Address - Country:US
Practice Address - Phone:847-615-5450
Practice Address - Fax:847-615-1783
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-001588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional