Provider Demographics
NPI:1265595755
Name:FINK, SUZANNE (LPC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:FINK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:RIVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1823 NEWTON ST NW APT 105
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1036
Mailing Address - Country:US
Mailing Address - Phone:602-380-4872
Mailing Address - Fax:
Practice Address - Street 1:2100 WASHINGTON BLVD FL 4
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5717
Practice Address - Country:US
Practice Address - Phone:703-228-1754
Practice Address - Fax:703-228-1174
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC2323101Y00000X
VA0701005166101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ756794OtherAHCCS