Provider Demographics
NPI:1841724887
Name:SCHWENDENER, SUSAN RUTH (LPC, AMFT)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:RUTH
Last Name:SCHWENDENER
Suffix:
Gender:F
Credentials:LPC, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 N POE ST APT B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-4932
Mailing Address - Country:US
Mailing Address - Phone:773-750-7890
Mailing Address - Fax:
Practice Address - Street 1:1881 N POE ST APT B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4932
Practice Address - Country:US
Practice Address - Phone:773-750-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.012191101YP2500X
IL208.000508106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional