Provider Demographics
NPI:1750517868
Name:SKLAR, SUSAN ELLEN (LMHC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELLEN
Last Name:SKLAR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 SE COVE LAKE CIR APT 108
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-4319
Mailing Address - Country:US
Mailing Address - Phone:727-254-2546
Mailing Address - Fax:
Practice Address - Street 1:4333 SE COVE LAKE CIR APT 108
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-4319
Practice Address - Country:US
Practice Address - Phone:727-254-2546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9229101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor