Provider Demographics
NPI:1922729425
Name:KOMANSKI, SUZANNE RENEE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:RENEE
Last Name:KOMANSKI
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 LONGHORN LN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:MN
Mailing Address - Zip Code:55313-5043
Mailing Address - Country:US
Mailing Address - Phone:407-758-6833
Mailing Address - Fax:
Practice Address - Street 1:311 BRIGHTON AVE S STE B
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-2313
Practice Address - Country:US
Practice Address - Phone:407-900-3494
Practice Address - Fax:763-951-2820
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health