Provider Demographics
NPI:1558460857
Name:GREGG, SUZANNE GETZ (PHD, LPC, RPT/S)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:GETZ
Last Name:GREGG
Suffix:
Gender:F
Credentials:PHD, LPC, RPT/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 VIRGINIA BEACH BLVD
Mailing Address - Street 2:PMB 181
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4419
Mailing Address - Country:US
Mailing Address - Phone:757-422-2408
Mailing Address - Fax:757-422-4162
Practice Address - Street 1:1092 LASKIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6362
Practice Address - Country:US
Practice Address - Phone:757-422-2408
Practice Address - Fax:757-422-4162
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001580101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional