| Doctor Name: | SUSAN K. LEVERIDGE |
| NPI Number: | 1598153207 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMHC |
| License Number: | LH60551031 |
| Business Practice Address: | 8226 Bracken Pl Se Ste 200 Snoqualmie, WA - 980659235 |
| Business Phone Number: | 2069302238 |
| Business Fax Number: | |
| Mailing Address: | 8226 Bracken Pl Se Ste 200, SNOQUALMIE |
| State: | WA |
| Postal Code: | 980659235 |
| Phone Number: | 2069302238 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2015 |
| NPI Last Update Date: | 11/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH60551031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |