Provider Demographics
NPI:1467666750
Name:LEYPOLDT, SUZANNE DANIELLE (LMHP, CPC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:DANIELLE
Last Name:LEYPOLDT
Suffix:
Gender:F
Credentials:LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7902 GREENE CIR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-2029
Mailing Address - Country:US
Mailing Address - Phone:402-210-4451
Mailing Address - Fax:
Practice Address - Street 1:4545 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3232
Practice Address - Country:US
Practice Address - Phone:402-533-6000
Practice Address - Fax:402-553-2428
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1722101YP2500X
NE3400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional