Provider Demographics
NPI:1134416589
Name:SUCHARSKI, ALANA BROOKE (LPC)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:BROOKE
Last Name:SUCHARSKI
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 1:821 HILLSBORO RD APT 65
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1643
Mailing Address - Country:US
Mailing Address - Phone:573-631-2297
Mailing Address - Fax:
Practice Address - Street 1:821 HILLSBORO RD APT 65
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1643
Practice Address - Country:US
Practice Address - Phone:573-631-2297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20007012426101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO45-2687783OtherEIN