Provider Demographics
NPI:1992187017
Name:FOLEY, SUZANNA JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:JEAN
Last Name:FOLEY
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 1:2525 W COUNTY ROAD 4
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-8401
Mailing Address - Country:US
Mailing Address - Phone:806-341-5653
Mailing Address - Fax:
Practice Address - Street 1:2525 W COUNTY ROAD 4
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-8401
Practice Address - Country:US
Practice Address - Phone:806-341-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70879101YP2500X
CO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional