MEDICARE: SUZETTE J AIKEN LCMHC

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	101YM0800X	Mental Health Counselor	14949	NC

General Provider Information

NPI Number	:	1336771211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZETTE J AIKEN LCMHC

Provider Business Mailing Address
First Line	:	1315 NICKLAUS DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-1594
Country	:	US
Telephone Number	:	919-724-9119
Fax Number	:	919-432-4354

Provider Business Practice Location Address
First Line	:	1315 NICKLAUS DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-1594
Country	:	US
Telephone Number	:	919-724-0700
Fax Number	:	919-432-4354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2020
Last Update Date	:	01/07/2025

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