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Individual
MS. SUSAN ROBERTA DAVIS
Active
Individual
MS. SUSAN ROBERTA DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, CDS
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
180.007623
IL
101YP2500X
Professional Counselor
Primary
180.007623
IL
103TS0200X
School Psychologist
SS12630298P
IL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.007623
LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
01
—
SS12630298P
D.T., SCH PSYCH, EVALS
IL
Enumeration date
05/26/2006
Last updated
02/06/2025
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