Healthcare Provider Details

I. General information

NPI: 1932613791
Provider Name (Legal Business Name): SUSAN SHEKUT LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2017
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 SUNFOREST CT FL 2
TOLEDO OH
43623-4485
US

IV. Provider business mailing address

9505 EVIEDALE RD
SYLVANIA OH
43560-9251
US

V. Phone/Fax

Practice location:
  • Phone: 773-206-1866
  • Fax:
Mailing address:
  • Phone: 773-206-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180011295
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: