Provider Demographics
NPI:1457750390
Name:MCCURLEY, SUZANNE (LPC INTERN)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
Last Name:MCCURLEY
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 PASADENA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1947
Mailing Address - Country:US
Mailing Address - Phone:512-751-3141
Mailing Address - Fax:
Practice Address - Street 1:15112 THATCHER DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4629
Practice Address - Country:US
Practice Address - Phone:512-964-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-16
Last Update Date:2014-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional