Provider Demographics
NPI:1497508568
Name:ROEVER, SUSANNE ELIZABETH (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNE
Middle Name:ELIZABETH
Last Name:ROEVER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 GLENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3309
Mailing Address - Country:US
Mailing Address - Phone:336-662-5525
Mailing Address - Fax:
Practice Address - Street 1:7 CORPORATE CENTER CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-3878
Practice Address - Country:US
Practice Address - Phone:336-257-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health