Provider Demographics
NPI:1063710838
Name:SUEHS, TORY D M (MA, LPC)
Entity type:Individual
Prefix:
First Name:TORY
Middle Name:D M
Last Name:SUEHS
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:N5417 COUNTY ROAD B
Mailing Address - Street 2:
Mailing Address - City:MANAWA
Mailing Address - State:WI
Mailing Address - Zip Code:54949-8611
Mailing Address - Country:US
Mailing Address - Phone:920-931-4745
Mailing Address - Fax:920-221-0422
Practice Address - Street 1:750 BOWLING LN
Practice Address - Street 2:
Practice Address - City:WAUPACA
Practice Address - State:WI
Practice Address - Zip Code:54981-7707
Practice Address - Country:US
Practice Address - Phone:920-931-4745
Practice Address - Fax:920-221-0422
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6111-125101Y00000X, 101YP2500X
WI6111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor