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General NPI Number Information
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NPI Number | 1023456233
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Entity Type | Individual
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Provider Name | SUSAN LYNN AYERS MS, LPC, LCDC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 15927 W BELLEFONTAINE WAY
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City | TOMBALL
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State | TX
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Zip | 77377-2538
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Country | US
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Telephone | 281-379-1113
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Fax |
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Provider Business Mailing Address
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Address Line | 15927 W BELLEFONTAINE WAY
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City | TOMBALL
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State | TX
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Zip | 77377-2538
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Country | US
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Telephone | 281-379-1113
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3161
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10762
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License Number State | TX
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