Provider Demographics
NPI:1871591008
Name:SUSMAN, PATRICIA GERTA (LPC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:GERTA
Last Name:SUSMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 BRIAR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-1213
Mailing Address - Country:US
Mailing Address - Phone:713-781-2170
Mailing Address - Fax:713-781-2176
Practice Address - Street 1:2450 FONDREN RD
Practice Address - Street 2:SUITE 312
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2318
Practice Address - Country:US
Practice Address - Phone:712-789-7560
Practice Address - Fax:713-789-7351
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional