Provider Demographics
NPI:1932326972
Name:AERY, SUSAN M (LMHC, CAP, NCC, ACS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:AERY
Suffix:
Gender:F
Credentials:LMHC, CAP, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 N WICKHAM RD APT 12-102
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2242
Mailing Address - Country:US
Mailing Address - Phone:321-290-0668
Mailing Address - Fax:
Practice Address - Street 1:2727 N WICKHAM RD APT 12-102
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2242
Practice Address - Country:US
Practice Address - Phone:321-290-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 4689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health