Individual
SUSAN M SEBASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CSAC. INDCS
Contact information
Practice address
162 W MAIN ST, SUITE G, WHITEWATER, WI 53190-1995
(608) 446-0888
(866) 289-2601
Mailing address
162 W MAIN ST, SUITE G, WHITEWATER, WI 53190-1995
(608) 446-0888
(866) 289-2601
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2050-132
WI
101YP2500X
Professional Counselor
Primary
3734-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39394800
—
WI
Enumeration date
01/23/2007
Last updated
12/09/2008
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