Provider Demographics
NPI:1487911350
Name:SMITH, SUSAN JOY (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JOY
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 S LINCOLN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2720
Mailing Address - Country:US
Mailing Address - Phone:720-432-1403
Mailing Address - Fax:303-989-0099
Practice Address - Street 1:8089 S LINCOLN ST STE 203
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2720
Practice Address - Country:US
Practice Address - Phone:720-432-1403
Practice Address - Fax:303-989-0099
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4734101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional