Provider Demographics
NPI:1548607542
Name:PRAETZ, SUSAN M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:PRAETZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1807
Mailing Address - Country:US
Mailing Address - Phone:978-710-9877
Mailing Address - Fax:978-225-0932
Practice Address - Street 1:99 MARKET ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1807
Practice Address - Country:US
Practice Address - Phone:978-710-9877
Practice Address - Fax:978-225-0932
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health