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General NPI Number Information
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NPI Number | 1932613791
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Entity Type | Individual
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Provider Name | SUSAN SHEKUT LCPC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2017
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 825 N CASS AVE STE 115
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City | WESTMONT
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State | IL
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Zip | 60559-6401
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Country | US
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Telephone | 773-206-1866
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Fax | 773-345-0415
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Provider Business Mailing Address
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Address Line | 9505 EVIEDALE RD
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City | SYLVANIA
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State | OH
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Zip | 43560-9251
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Country | US
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Telephone | 773-206-9676
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Fax | 773-345-0415
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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 | 180011295
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License Number State | IL
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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 |
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License Number State |
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