Provider Demographics
NPI:1194939256
Name:NORSIGIAN, SUSAN (LCPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:NORSIGIAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N RUBY LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:62208-1926
Mailing Address - Country:US
Mailing Address - Phone:618-398-4226
Mailing Address - Fax:618-398-1759
Practice Address - Street 1:125 N RUBY LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:62208-1926
Practice Address - Country:US
Practice Address - Phone:618-398-4226
Practice Address - Fax:618-398-1759
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO216576OtherBCBS MO