Provider Demographics
NPI:1104544188
Name:STRAIN, SUSAN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:STRAIN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BOUCHILLION DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6182
Mailing Address - Country:US
Mailing Address - Phone:864-434-1437
Mailing Address - Fax:
Practice Address - Street 1:11 DAVIS KEATS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6509
Practice Address - Country:US
Practice Address - Phone:864-434-1437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist