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1417288176

NPI Code Detail

MEDICARE: SUZANNE MARY DOYLE LCMHC

MEDICARE: SUZANNE MARY DOYLE 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	001077	CT
2	101YM0800X	Mental Health Counselor	003498	CT
3	101YA0400X	Addiction (Substance Use Disorder) Counselor
4	101YM0800X	Mental Health Counselor	61175888	WA
5	101YP2500X	Professional Counselor	02590	MN
6	101YM0800X	Mental Health Counselor	14402	NC
7	101YM0800X	Mental Health Counselor	864	HI
8	101YP2500X	Professional Counselor	C6520	OR
9	101YM0800X	Mental Health Counselor	LH61175888	WA

General Provider Information

NPI Number	:	1417288176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE MARY DOYLE LCMHC

Provider Business Mailing Address
First Line	:	2283 BRECKNOCK DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-6554
Country	:	US
Telephone Number	:	336-346-8004
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CALIFORNIA ST STE 2300
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-5424
Country	:	US
Telephone Number	:	844-413-2811
Fax Number	:	206-339-1499

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

Provider Enumeration Date	:	01/20/2010
Last Update Date	:	11/22/2024

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Directions to “ SUZANNE MARY DOYLE LCMHC” Practice Location

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