Provider Demographics
NPI:1184932162
Name:OLIVER, SUZANNE R (LMHC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:R
Last Name:OLIVER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:R
Other - Last Name:STAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 1235
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221
Mailing Address - Country:US
Mailing Address - Phone:360-941-3324
Mailing Address - Fax:206-965-9713
Practice Address - Street 1:1015 6TH STREET #101
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221
Practice Address - Country:US
Practice Address - Phone:360-941-3324
Practice Address - Fax:206-965-9713
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60166575101YM0800X
WALH60281237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health