Provider Demographics
NPI:1518374289
Name:WINGFIELD, SUANNA (LPC)
Entity type:Individual
Prefix:
First Name:SUANNA
Middle Name:
Last Name:WINGFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 W RUSSELL RD STE 240
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1425
Mailing Address - Country:US
Mailing Address - Phone:702-793-4493
Mailing Address - Fax:702-793-4301
Practice Address - Street 1:9205 W RUSSELL RD STE 240
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-793-4493
Practice Address - Fax:702-793-4301
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1309092101YM0800X
NVCP0242101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor