Provider Demographics
NPI:1649334111
Name:SUABEDISSEN, ANN M (LPC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:SUABEDISSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:MUEHLEISEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ASHURST LN
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1202
Mailing Address - Country:US
Mailing Address - Phone:609-306-3197
Mailing Address - Fax:
Practice Address - Street 1:100 ASHURST LN
Practice Address - Street 2:SUITE 209
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1202
Practice Address - Country:US
Practice Address - Phone:609-306-3197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00128900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health