Provider Demographics
NPI:1497386338
Name:HORVAT, SUSAN (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:HORVAT
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 190TH ST APT 139
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-5424
Mailing Address - Country:US
Mailing Address - Phone:612-244-3836
Mailing Address - Fax:
Practice Address - Street 1:3838 W CARSON ST STE 333
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6710
Practice Address - Country:US
Practice Address - Phone:657-464-5296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health