Provider Demographics
NPI:1679692149
Name:BUCHALTER, SUSAN IRENE (MA, ATR-BC,CGP,LPC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:IRENE
Last Name:BUCHALTER
Suffix:
Gender:F
Credentials:MA, ATR-BC,CGP,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 MOUNT LUCAS RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1911
Mailing Address - Country:US
Mailing Address - Phone:609-497-3347
Mailing Address - Fax:
Practice Address - Street 1:741 MOUNT LUCAS RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1911
Practice Address - Country:US
Practice Address - Phone:609-497-3347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC1513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health