Provider Demographics
NPI:1841538055
Name:ORNELAS, SUZANNE MARIE (LPCC)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARIE
Last Name:ORNELAS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:CALDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:2012 W MANN AVE
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-2257
Mailing Address - Country:US
Mailing Address - Phone:575-365-7335
Mailing Address - Fax:
Practice Address - Street 1:1105 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1189
Practice Address - Country:US
Practice Address - Phone:575-746-9848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0083921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional