Provider Demographics
NPI:1639217755
Name:SWEET, SUSAN LH (MFT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LH
Last Name:SWEET
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:L
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 W PERKINS ST STE 203
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4859
Mailing Address - Country:US
Mailing Address - Phone:707-671-5122
Mailing Address - Fax:707-671-9072
Practice Address - Street 1:216 W PERKINS ST STE 203
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4859
Practice Address - Country:US
Practice Address - Phone:707-671-5122
Practice Address - Fax:707-671-9072
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44801106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist