Provider Demographics
NPI:1063210854
Name:SCHILT, SUSAN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SCHILT
Suffix:
Gender:
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 AIRPORT PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1542
Mailing Address - Country:US
Mailing Address - Phone:307-632-7771
Mailing Address - Fax:307-632-9697
Practice Address - Street 1:1401 AIRPORT PKWY STE 240
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1542
Practice Address - Country:US
Practice Address - Phone:307-632-7771
Practice Address - Fax:307-632-9697
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1372101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional