Provider Demographics
NPI:1184743916
Name:FRYDMAN LEVIN, SUSANA B (M ED,LMHC)
Entity type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:B
Last Name:FRYDMAN LEVIN
Suffix:
Gender:F
Credentials:M ED,LMHC
Other - Prefix:
Other - First Name:SUSANA
Other - Middle Name:B
Other - Last Name:FRYDMAN DE LEVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8400 LOUISIANA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6385
Mailing Address - Country:US
Mailing Address - Phone:219-757-1928
Mailing Address - Fax:219-757-1950
Practice Address - Street 1:3903 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-2555
Practice Address - Country:US
Practice Address - Phone:219-398-7050
Practice Address - Fax:219-392-6998
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2016-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEPLMHP8253101YM0800X
IN39002833A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health