Provider Demographics
NPI:1568886703
Name:DAVIS, SUZANNE OVERSTREET (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:OVERSTREET
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:FLORENCE
Other - Last Name:OVERSTREET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:517 RUBY COURT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:540-420-0306
Mailing Address - Fax:
Practice Address - Street 1:916 BUTTS STATION RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3120
Practice Address - Country:US
Practice Address - Phone:757-615-6476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional