Provider Demographics
NPI:1629501929
Name:HARGETT, SUSAN (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HARGETT
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16314 CLYDESDALE RUN
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3863
Mailing Address - Country:US
Mailing Address - Phone:210-718-8301
Mailing Address - Fax:
Practice Address - Street 1:116 GALLERY CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3340
Practice Address - Country:US
Practice Address - Phone:210-802-4695
Practice Address - Fax:210-802-4698
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72318101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional