Provider Demographics
NPI:1942533609
Name:FREITAG, SUSAN A (LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:A
Last Name:FREITAG
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-5365
Mailing Address - Country:US
Mailing Address - Phone:931-372-7117
Mailing Address - Fax:931-372-7119
Practice Address - Street 1:3380 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-5365
Practice Address - Country:US
Practice Address - Phone:931-372-7117
Practice Address - Fax:931-372-7119
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor