Provider Demographics
NPI:1780932152
Name:WATTS, SUZANNE UNA (MA LPC)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:UNA
Last Name:WATTS
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:UNA
Other - Last Name:EARL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3505 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-1460
Mailing Address - Country:US
Mailing Address - Phone:678-288-6261
Mailing Address - Fax:
Practice Address - Street 1:3505 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE 5B
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-1460
Practice Address - Country:US
Practice Address - Phone:678-288-6261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional