Provider Demographics
NPI:1720296114
Name:LOUD, SUSAN C (LMHC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:C
Last Name:LOUD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 MAIN STREET
Mailing Address - Street 2:STE 332
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3130
Mailing Address - Country:US
Mailing Address - Phone:413-585-0689
Mailing Address - Fax:413-584-8685
Practice Address - Street 1:25 MAIN STREET
Practice Address - Street 2:STE 332
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3130
Practice Address - Country:US
Practice Address - Phone:413-585-0689
Practice Address - Fax:413-584-8685
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3245101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
012787OtherHARVARD ALARM
MALM0480OtherBLUE CROSS BLUE SHIELD