MEDICARE: SUSAN HERRBOLD LPC, NCC

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	8916	TX

General Provider Information

NPI Number	:	1467678730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN HERRBOLD LPC, NCC

Provider Business Mailing Address
First Line	:	8812 GRAND AVE
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-1700
Country	:	US
Telephone Number	:	214-770-5104
Fax Number	:

Provider Business Practice Location Address
First Line	:	8812 GRAND AVE
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-1700
Country	:	US
Telephone Number	:	214-770-5104
Fax Number	:

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	10/06/2025

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