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General NPI Number Information
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NPI Number | 1346521481
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Entity Type | Organization
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Legal Business Name | SUSAN K KAUFFMAN LMHC PLLC
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 07/09/2022
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Provider Practice Location Address
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Address Line | 146 DEPOT ST STE 202
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City | BLUE RIDGE
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State | GA
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Zip | 30513-8503
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Country | US
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Telephone | 941-780-4192
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1157
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City | MC CAYSVILLE
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State | GA
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Zip | 30555-1157
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Country | US
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Telephone | 941-780-4192
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Fax | 706-964-6111
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN K KAUFFMAN
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Credential | LMHC
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Telephone | 941-780-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH2837
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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