Provider Demographics
NPI:1942783618
Name:SAUCEDO, SUZETTE (LPC)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:SAUCEDO
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 1:6070 GATEWAY BLVD E STE E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2019
Mailing Address - Country:US
Mailing Address - Phone:915-800-3165
Mailing Address - Fax:
Practice Address - Street 1:6070 GATEWAY BLVD E STE E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2019
Practice Address - Country:US
Practice Address - Phone:915-800-3165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77033101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health