Provider Demographics
NPI:1730316407
Name:SUITOR, CARLA D (MS LPC LADC)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:D
Last Name:SUITOR
Suffix:
Gender:F
Credentials:MS LPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22678 ROUTE 66 N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-7516
Mailing Address - Country:US
Mailing Address - Phone:580-225-4337
Mailing Address - Fax:580-225-4338
Practice Address - Street 1:1021 E HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-1906
Practice Address - Country:US
Practice Address - Phone:580-225-4337
Practice Address - Fax:580-225-4338
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK286101YA0400X
OK2029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)