=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588008114
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUZANNE L MCINTEE MED, LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2013
-----------------------------------------------------
Last Update Date | 03/29/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 581 BOSTON MILLS RD STE 400
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44236-1193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-348-4459
-----------------------------------------------------
Fax | 234-274-8284
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 581 BOSTON MILLS RD STE 400
-----------------------------------------------------
City | HUDSON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44236-1193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 234-348-4459
-----------------------------------------------------
Fax | 234-274-8284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | E.0004218
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------