Provider Demographics
NPI:1053556993
Name:THURBER, DARLEEN SUSANNE (PHD, LPC)
Entity type:Individual
Prefix:
First Name:DARLEEN
Middle Name:SUSANNE
Last Name:THURBER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9504 96TH CT
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-1470
Mailing Address - Country:US
Mailing Address - Phone:936-555-4545
Mailing Address - Fax:
Practice Address - Street 1:3615 HUTCHINSON RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-9099
Practice Address - Country:US
Practice Address - Phone:936-555-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health