Provider Demographics
NPI:1396049151
Name:KOVAL, SUSAN M (MA, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:KOVAL
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ENTRANCE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-1202
Mailing Address - Country:US
Mailing Address - Phone:724-331-3925
Mailing Address - Fax:
Practice Address - Street 1:12 ENTRANCE DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-1202
Practice Address - Country:US
Practice Address - Phone:724-331-3925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA006023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health