Provider Demographics
NPI:1982297743
Name:SUSAN PRAETZ LMHC, LADC-1 P.C.
Entity Type:Organization
Organization Name:SUSAN PRAETZ LMHC, LADC-1 P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRAETZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LADC-1
Authorized Official - Phone:617-816-6462
Mailing Address - Street 1:36 AUTRAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4307
Mailing Address - Country:US
Mailing Address - Phone:617-816-6462
Mailing Address - Fax:
Practice Address - Street 1:4 HIGH ST # 109
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2620
Practice Address - Country:US
Practice Address - Phone:617-816-6462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty