Individual
MS. SUSAN K KAUFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
146 DEPOT ST STE 202, BLUE RIDGE, GA 30513-8503
(706) 964-6111
(706) 964-6111
Mailing address
PO BOX 1157, MC CAYSVILLE, GA 30555-1157
(941) 780-4192
(706) 964-6111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH2837
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
421634908
FEDERAL TAX ID
FL
01
—
Z5963
BCBS
FL
Enumeration date
09/07/2005
Last updated
04/06/2022
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