Healthcare Provider Details

I. General information

NPI: 1659701514
Provider Name (Legal Business Name): SUSANNE HOBEN MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSANNE HAYDEN

II. Dates (important events)

Enumeration Date: 11/13/2013
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W MAIN ST
ROBINSON IL
62454-3819
US

IV. Provider business mailing address

16453 N 1150TH ST STE 102
HUTSONVILLE IL
62433-2701
US

V. Phone/Fax

Practice location:
  • Phone: 224-678-9180
  • Fax: 224-678-9369
Mailing address:
  • Phone: 815-545-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.012219
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: