Provider Demographics
NPI:1649857731
Name:GATTES, SUZI (MA)
Entity type:Individual
Prefix:MRS
First Name:SUZI
Middle Name:
Last Name:GATTES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 CENTRAL PARK DR UNIT 51
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48805-5003
Mailing Address - Country:US
Mailing Address - Phone:517-899-4712
Mailing Address - Fax:
Practice Address - Street 1:419 N MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1856
Practice Address - Country:US
Practice Address - Phone:517-482-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)