Individual provider · Type 1 NPI

Shasta Hickman-Suppes, LMHC

Mental Health Counselor · Salem, OR

NPI number 1245885250 Active

Practice location

1400 Broadway St NE Ste 206
Salem, OR 97301-0504

Call (971) 303-9868 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XLH61102916 (WA)
Mental Health Counselor Primary 101YM0800XC6107 (OR)
Mental Health Counselor 101YM0800XMC60943341 (WA)

Mental Health Counselor: Definition to come...

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About NPI 1245885250

Shasta Hickman-Suppes, LMHC's National Provider Identifier is 1245885250, issued on Aug 6, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Salem, OR. The record was last updated on Jul 8, 2026.