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General NPI Number Information
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NPI Number | 1588689657
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Entity Type | Individual
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Provider Name | SUSAN MACNEIL HOUTKOOPER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 140 W 79TH ST 1E
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City | NEW YORK
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State | NY
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Zip | 10024-6421
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Country | US
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Telephone | 212-799-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 247 W 72ND ST 2RE
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City | NEW YORK
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State | NY
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Zip | 10023-2723
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Country | US
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Telephone | 212-316-7021
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002106
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License Number State | NY
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