Provider Demographics
NPI:1790091288
Name:LOFTUS, SUZANNE L (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:L
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2964
Mailing Address - Country:US
Mailing Address - Phone:516-509-2430
Mailing Address - Fax:
Practice Address - Street 1:146 SOUTH COUNTRY ROAD
Practice Address - Street 2:SOUTH COUNTRY SUITES, UNIT 1
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-3121
Practice Address - Country:US
Practice Address - Phone:516-509-2430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist