Provider Demographics
NPI:1861574386
Name:WINKELSPECHT, SUSAN M (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:M
Last Name:WINKELSPECHT
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 W CONCHO AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6461
Mailing Address - Country:US
Mailing Address - Phone:325-657-0058
Mailing Address - Fax:
Practice Address - Street 1:133 W CONCHO AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6461
Practice Address - Country:US
Practice Address - Phone:325-657-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional