Provider Demographics
NPI:1487880019
Name:HESS, SUSAN J (LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:HESS
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 1:3719 EVERGREEN PKWY STE A-102
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7771
Mailing Address - Country:US
Mailing Address - Phone:303-246-5162
Mailing Address - Fax:
Practice Address - Street 1:4881 FOREST HILL RD
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-5723
Practice Address - Country:US
Practice Address - Phone:303-246-5162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3728101YP2500X
05426225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist