Healthcare Provider Details

I. General information

NPI: 1285906891
Provider Name (Legal Business Name): SUSAN DIANN AGYEMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUSAN DIANN CARTER MA, NCC

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 DAYBREAK CIR
HARRISBURG PA
17110-9296
US

IV. Provider business mailing address

2002 DAYBREAK CIR
HARRISBURG PA
17110-9296
US

V. Phone/Fax

Practice location:
  • Phone: 717-473-9500
  • Fax:
Mailing address:
  • Phone: 717-473-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC008605
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: