Provider Demographics
NPI:1457446981
Name:STANKOVIC, SUZANA MARIJAN (LPC)
Entity Type:Individual
Prefix:
First Name:SUZANA
Middle Name:MARIJAN
Last Name:STANKOVIC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 CLARIDGE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096
Mailing Address - Country:US
Mailing Address - Phone:713-777-8774
Mailing Address - Fax:
Practice Address - Street 1:6750 WEST LOOP SOUTH
Practice Address - Street 2:SUITE 225
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-494-3807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15250101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional