Provider Demographics
NPI:1548552573
Name:PRUSHINSKI, SUSAN MARIE (LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARIE
Last Name:PRUSHINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:PRUSHINSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC, CCPT
Mailing Address - Street 1:135 HONEY POT STREET - REAR
Mailing Address - Street 2:
Mailing Address - City:NANTICOKE
Mailing Address - State:PA
Mailing Address - Zip Code:18634-1541
Mailing Address - Country:US
Mailing Address - Phone:570-328-4070
Mailing Address - Fax:570-276-2098
Practice Address - Street 1:135 HONEY POT STREET - REAR
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-1541
Practice Address - Country:US
Practice Address - Phone:570-933-2861
Practice Address - Fax:570-276-2098
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006669101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional