Provider Demographics
NPI:1508580994
Name:SUSANNA DOSS COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:SUSANNA DOSS COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:254-716-0115
Mailing Address - Street 1:616 LISTER DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-2119
Mailing Address - Country:US
Mailing Address - Phone:254-716-0115
Mailing Address - Fax:
Practice Address - Street 1:8414-B OLD MCGREGOR RD
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-7671
Practice Address - Country:US
Practice Address - Phone:254-716-0115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty