Provider Demographics
NPI:1609949791
Name:SULESKI, LINDA ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:SULESKI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANNE
Other - Last Name:SULESKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:458 OLD CHEROKEE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6971
Mailing Address - Country:US
Mailing Address - Phone:803-521-9929
Mailing Address - Fax:
Practice Address - Street 1:458 OLD CHEROKEE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-6971
Practice Address - Country:US
Practice Address - Phone:803-521-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist