Provider Demographics
NPI:1699916437
Name:BACKMAN YORTON, SUZANNE J (LMHC)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:J
Last Name:BACKMAN YORTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:J
Other - Last Name:YORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:941 WALKER HEIGHTS PL
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8189
Mailing Address - Country:US
Mailing Address - Phone:360-929-7757
Mailing Address - Fax:360-240-8369
Practice Address - Street 1:941 WALKER HEIGHTS PL
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-8189
Practice Address - Country:US
Practice Address - Phone:360-929-7757
Practice Address - Fax:360-240-8369
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60022394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH 60022394OtherLICENSED MENTAL HEALTH COUNSELOR