Provider Demographics
NPI:1528522448
Name:HAMDAN, SUSAN (LCPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SORREL
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-9735
Mailing Address - Country:US
Mailing Address - Phone:708-743-7892
Mailing Address - Fax:
Practice Address - Street 1:2 SORREL
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9735
Practice Address - Country:US
Practice Address - Phone:708-743-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180013316101YM0800X, 101YP2500X
178013837101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health