Provider Demographics
NPI:1366067357
Name:WHITE-HOUSE, SUZAN APRIL (LHMC)
Entity type:Individual
Prefix:
First Name:SUZAN
Middle Name:APRIL
Last Name:WHITE-HOUSE
Suffix:
Gender:F
Credentials:LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 SAN JUAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-8516
Mailing Address - Country:US
Mailing Address - Phone:904-466-1009
Mailing Address - Fax:360-873-8463
Practice Address - Street 1:4133 SAN JUAN BLVD
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-8516
Practice Address - Country:US
Practice Address - Phone:904-466-1009
Practice Address - Fax:360-873-8463
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC03649101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health