Provider Demographics
NPI:1710033105
Name:LONSWAY, SUE LEE (MED)
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:LEE
Last Name:LONSWAY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MS
Other - First Name:SUE
Other - Middle Name:LEEANNE
Other - Last Name:FERANCY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:2325 GIBLEY PK DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617
Mailing Address - Country:US
Mailing Address - Phone:419-350-5116
Mailing Address - Fax:419-841-9065
Practice Address - Street 1:3540 SECOR RD
Practice Address - Street 2:SUITE 305
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-350-5116
Practice Address - Fax:419-841-9065
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002653101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000295129OtherANTHEM
0004409318OtherAETNA