Provider Demographics
NPI:1508881921
Name:KAISER, SUSANNE (MA, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16818
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-6818
Mailing Address - Country:US
Mailing Address - Phone:919-357-2050
Mailing Address - Fax:919-968-2998
Practice Address - Street 1:1829 E FRANKLIN ST
Practice Address - Street 2:SUITE 100-D
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5861
Practice Address - Country:US
Practice Address - Phone:919-357-2050
Practice Address - Fax:919-968-2998
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4343101YP2500X, 101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1335FOtherBCBS OF NC
NCC9718OtherMEDCOST
NC6102880Medicaid
NC2172228OtherCIGNA BEHAVIORAL
NCE1323OtherMEDCOST