| Doctor Name: | SUSANNA WETHERINGTON |
| NPI Number: | 1083071013 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 69148 |
| Business Practice Address: | 5000 Bee Caves Rd Ste 100 West Lake Hills, TX - 787465254 |
| Business Phone Number: | 5125932977 |
| Business Fax Number: | |
| Mailing Address: | 3809 Spicewood Springs Rd, 148 AUSTIN |
| State: | TX |
| Postal Code: | 787598963 |
| Phone Number: | 2147969910 |
| Fax Number: | |
| NPI Enumeration Date: | 01/21/2016 |
| NPI Last Update Date: | 01/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 69148 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |