Provider Demographics
NPI:1700195633
Name:RINGHAUSEN, SUSANNE PALLADINO (MA)
Entity Type:Individual
Prefix:MS
First Name:SUSANNE
Middle Name:PALLADINO
Last Name:RINGHAUSEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 SAINT ANTHONYS WAY
Mailing Address - Street 2:PO BOX 340
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-4568
Mailing Address - Country:US
Mailing Address - Phone:618-463-5730
Mailing Address - Fax:618-465-1355
Practice Address - Street 1:815 E 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6471
Practice Address - Country:US
Practice Address - Phone:618-463-5730
Practice Address - Fax:618-465-1355
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.002754101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional