Provider Demographics
NPI:1689030108
Name:SUELZER, MARCIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:SUELZER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 WOOD CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ISLAND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60042-9590
Mailing Address - Country:US
Mailing Address - Phone:815-355-5395
Mailing Address - Fax:
Practice Address - Street 1:714 WOOD CREEK CT
Practice Address - Street 2:
Practice Address - City:ISLAND LAKE
Practice Address - State:IL
Practice Address - Zip Code:60042-9590
Practice Address - Country:US
Practice Address - Phone:815-355-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010949101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional