Provider Demographics
NPI:1831113737
Name:HAMILTON, SUZANNE B (LPC)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:B
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 E. WORTHY RD.
Mailing Address - Street 2:SUITE D
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-2558
Mailing Address - Country:US
Mailing Address - Phone:225-253-9635
Mailing Address - Fax:
Practice Address - Street 1:1026 E. WORTHY RD.
Practice Address - Street 2:SUITE D
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-2558
Practice Address - Country:US
Practice Address - Phone:225-253-9635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11562836OtherCAQH