Provider Demographics
NPI:1417288176
Name:DOYLE, SUZANNE MARY (LCMHC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARY
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 S MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-5808
Mailing Address - Country:US
Mailing Address - Phone:336-722-7266
Mailing Address - Fax:336-201-0538
Practice Address - Street 1:100 DENNY WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4049
Practice Address - Country:US
Practice Address - Phone:206-888-4894
Practice Address - Fax:206-339-1499
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NC25304101YA0400X
CT001077101YA0400X
WA61175888101YM0800X
NC14402101YM0800X
CT003498101YM0800X
WALH61175888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)