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General NPI Number Information
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NPI Number | 1487285920
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Entity Type | Individual
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Provider Name | SUZAN MUHANNA MA, LPCC, LADC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 7505 METRO BLVD STE 505
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City | EDINA
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State | MN
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Zip | 55439-3018
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Country | US
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Telephone | 651-271-1665
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Fax | 612-999-1767
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Provider Business Mailing Address
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Address Line | 3300 OAKDALE AVE N
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City | ROBBINSDALE
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State | MN
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Zip | 55422-2926
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Country | US
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Telephone | 763-581-9778
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 305519
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License Number State | MN
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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 | CC03624
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License Number State | MN
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