Provider Demographics
NPI:1538508528
Name:BALKA, SUZANNE LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LYNN
Last Name:BALKA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1400 BROADFIELD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5163
Mailing Address - Country:US
Mailing Address - Phone:281-994-7861
Mailing Address - Fax:281-994-7801
Practice Address - Street 1:1400 BROADFIELD BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5163
Practice Address - Country:US
Practice Address - Phone:281-994-7861
Practice Address - Fax:281-994-7801
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-23
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional