Provider Demographics
NPI:1447398474
Name:SIMAN, SUZANNE (MACC, LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SIMAN
Suffix:
Gender:F
Credentials:MACC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SE MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2695
Mailing Address - Country:US
Mailing Address - Phone:864-553-0076
Mailing Address - Fax:864-963-5960
Practice Address - Street 1:304A NE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2319
Practice Address - Country:US
Practice Address - Phone:864-553-0076
Practice Address - Fax:877-201-4878
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5253101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator