Provider Demographics
NPI:1356592380
Name:SUZANNE MARIE ROULEAU HEARTS IN MIND COUNSELING
Entity type:Organization
Organization Name:SUZANNE MARIE ROULEAU HEARTS IN MIND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROULEAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-479-5157
Mailing Address - Street 1:8 BLUE JAY DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-1210
Mailing Address - Country:US
Mailing Address - Phone:302-479-5157
Mailing Address - Fax:
Practice Address - Street 1:1601 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4027
Practice Address - Country:US
Practice Address - Phone:302-479-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00006771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty