Provider Demographics
NPI:1447363874
Name:DROLET CONEYBEER, SUSAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:DROLET CONEYBEER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 N MCKEAN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5426
Mailing Address - Country:US
Mailing Address - Phone:724-282-0332
Mailing Address - Fax:724-282-2406
Practice Address - Street 1:349 N MCKEAN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5426
Practice Address - Country:US
Practice Address - Phone:724-282-0332
Practice Address - Fax:724-282-2406
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008242L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA207142OtherCCBH UPMC
PA237435OtherVALUE OPTIONS
263824OtherMAGELLAN
PA0017090540001Medicaid
PA263824OtherHIGHMARK
S58374Medicare UPIN
PA0017090540001Medicaid