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General NPI Number Information
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NPI Number | 1649777236
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Entity Type | Individual
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Provider Name | STEPHANIE LA SHA SUCHON MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 8118 FRY RD STE 203
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City | CYPRESS
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State | TX
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Zip | 77433-7851
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Country | US
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Telephone | 281-377-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 14090 FM 2920 RD STE G158
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City | TOMBALL
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State | TX
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Zip | 77377-5549
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Country | US
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Telephone | 832-524-4620
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 75625
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License Number State | TX
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