Provider Demographics
NPI:1750561585
Name:HORTON, SUZANNE JONELLE (MA LMHC)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:JONELLE
Last Name:HORTON
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8670
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98419-0670
Mailing Address - Country:US
Mailing Address - Phone:253-677-9499
Mailing Address - Fax:
Practice Address - Street 1:7828 S PARK AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-5313
Practice Address - Country:US
Practice Address - Phone:253-677-9499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60073130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health