Provider Demographics
NPI:1285762757
Name:SUSCHKE, GERILYN ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:GERILYN
Middle Name:ANN
Last Name:SUSCHKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NALBONE CT
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9777
Mailing Address - Country:US
Mailing Address - Phone:609-504-9588
Mailing Address - Fax:
Practice Address - Street 1:3620 QUAKERBRIDGE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1208
Practice Address - Country:US
Practice Address - Phone:609-403-6190
Practice Address - Fax:609-403-6191
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00297600101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health