Provider Demographics
NPI:1720409683
Name:SCHUERENBERG, SUSAN (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SCHUERENBERG
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 N BAY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-9080
Mailing Address - Country:US
Mailing Address - Phone:260-585-7109
Mailing Address - Fax:
Practice Address - Street 1:3525 N BAY VIEW RD
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-9080
Practice Address - Country:US
Practice Address - Phone:260-585-7109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002498A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health