Provider Demographics
NPI:1528491867
Name:SUGGS, CLEON EDWARD (SUBSTANCE ABUSE COUN)
Entity type:Individual
Prefix:MR
First Name:CLEON
Middle Name:EDWARD
Last Name:SUGGS
Suffix:
Gender:M
Credentials:SUBSTANCE ABUSE COUN
Other - Prefix:MR
Other - First Name:CLEON
Other - Middle Name:EDWARD
Other - Last Name:SUGGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ICS,CSAC
Mailing Address - Street 1:2821 N 4TH ST
Mailing Address - Street 2:208E
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-2362
Mailing Address - Country:US
Mailing Address - Phone:414-688-3062
Mailing Address - Fax:
Practice Address - Street 1:2677 N 40TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2505
Practice Address - Country:US
Practice Address - Phone:414-447-1964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11828-134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)