Individual
SUSAN KATHLEEN SHEARER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPAT
Contact information
Practice address
6200 CRESTWOOD STA, STE A, CRESTWOOD, KY 40014-7418
(502) 241-2909
(502) 241-6811
Mailing address
PO BOX 73070, CLEVELAND, OH 44193-0002
(502) 241-2909
(502) 241-6811
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0125
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0125
BOARD LICENSE ART THERAPY
KY
Enumeration date
08/31/2006
Last updated
07/08/2007
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