Provider Demographics
NPI:1578783908
Name:JEAN-PIERRE, SUSAN ANNE HONORE (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANNE HONORE
Last Name:JEAN-PIERRE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 ADAMS ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2837
Mailing Address - Country:US
Mailing Address - Phone:505-969-5999
Mailing Address - Fax:
Practice Address - Street 1:324 ADAMS ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-2837
Practice Address - Country:US
Practice Address - Phone:505-969-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health