Provider Demographics
NPI:1861639668
Name:NORTHEY, SUZANNE LYNNE (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:LYNNE
Last Name:NORTHEY
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 W IRON SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1614
Mailing Address - Country:US
Mailing Address - Phone:928-612-2368
Mailing Address - Fax:928-612-2369
Practice Address - Street 1:2700 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5415
Practice Address - Country:US
Practice Address - Phone:480-239-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-0456106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist