Provider Demographics
NPI:1538496625
Name:LOUGHMAN, SUZANNE CLAIRE (LPC, CSOTP)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:CLAIRE
Last Name:LOUGHMAN
Suffix:
Gender:F
Credentials:LPC, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EATON ST STE 1103
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4054
Mailing Address - Country:US
Mailing Address - Phone:757-838-1894
Mailing Address - Fax:757-838-1895
Practice Address - Street 1:2 EATON ST STE 1103
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4054
Practice Address - Country:US
Practice Address - Phone:757-838-1894
Practice Address - Fax:757-838-1895
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0812000577101Y00000X
MA6333101YM0800X
VA0701004445101YM0800X, 101YP2500X
VA11875101YP2500X
MA3132641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical