Provider Demographics
NPI:1982755674
Name:FAUNCE, SUSAN (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:FAUNCE
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 1:3639 CORTEZ ROAD WEST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3028
Mailing Address - Country:US
Mailing Address - Phone:941-321-1027
Mailing Address - Fax:
Practice Address - Street 1:3639 CORTEZ ROAD WEST
Practice Address - Street 2:SUITE 224
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3028
Practice Address - Country:US
Practice Address - Phone:941-321-1027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health