MEDICARE: MS. SUSAN S. HUNTER LPC

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	60976	TX

General Provider Information

NPI Number	:	1427210509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN S. HUNTER LPC

Provider Business Mailing Address
First Line	:	6017 REEF POINT LN
Second Line	:	SUITE 155
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7004
Country	:	US
Telephone Number	:	817-897-0252
Fax Number	:	817-237-8392

Provider Business Practice Location Address
First Line	:	6017 REEF POINT LN
Second Line	:	SUITE 155
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7004
Country	:	US
Telephone Number	:	817-980-0966
Fax Number	:	817-237-8392

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

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	01/24/2012

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