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General NPI Number Information
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NPI Number | 1861885410
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Entity Type | Individual
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Provider Name | SUSAN E. HAERR MA, LCPC, LPHA
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Gender | Female
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 205 S 24TH ST
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City | QUINCY
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State | IL
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Zip | 62301-4446
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Country | US
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Telephone | 217-223-7492
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Fax |
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Provider Business Mailing Address
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Address Line | 7026 COUNTY ROAD 308
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City | TAYLOR
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State | MO
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Zip | 63471-2036
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Country | US
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Telephone | 217-779-6734
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.011767
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.011298
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License Number State | IL
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