Provider Demographics
NPI:1417574823
Name:FREID, SUZANNE (LPC, NCC, PHD CAND)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FREID
Suffix:
Gender:F
Credentials:LPC, NCC, PHD CAND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W 38TH ST STE 428
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-6409
Mailing Address - Country:US
Mailing Address - Phone:512-454-3685
Mailing Address - Fax:512-454-3689
Practice Address - Street 1:1600 W 38TH ST STE 428
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6409
Practice Address - Country:US
Practice Address - Phone:512-454-3685
Practice Address - Fax:512-454-3689
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional