MEDICARE: SUE DEVINE COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1124590781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUE DEVINE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3425 LIMEKILN PIKE STE 9
Second Line	:
City	:	CHALFONT
State	:	PA
Zip	:	18914-3602
Country	:	US
Telephone Number	:	215-240-1976
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 LIMEKILN PIKE STE 9
Second Line	:
City	:	CHALFONT
State	:	PA
Zip	:	18914-3602
Country	:	US
Telephone Number	:	215-240-1976
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	SUZANNE MARIE DEVINE
Credential	:	LPC
Telephone Number	:	215-630-4453

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	03/13/2024

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