Provider Demographics
NPI:1285906891
Name:AGYEMAN, SUSAN DIANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DIANN
Last Name:AGYEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:DIANN
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, NCC
Mailing Address - Street 1:2002 DAYBREAK CIR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9296
Mailing Address - Country:US
Mailing Address - Phone:717-473-9500
Mailing Address - Fax:
Practice Address - Street 1:2002 DAYBREAK CIR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9296
Practice Address - Country:US
Practice Address - Phone:717-473-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional