Provider Demographics
NPI:1639233372
Name:RISER, SUSAN E (PHD, LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:RISER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 TALIAFERRO TRL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7758
Mailing Address - Country:US
Mailing Address - Phone:334-315-1370
Mailing Address - Fax:334-460-9972
Practice Address - Street 1:1785 TALIAFERRO TRL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7758
Practice Address - Country:US
Practice Address - Phone:334-398-8698
Practice Address - Fax:334-460-9972
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional