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NPI Code Detail

MEDICARE: MR. TODD ALAN SUSSMAN MS, LMHC, LMFT

MEDICARE: MR. TODD ALAN SUSSMAN MS, LMHC, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH 4507FL

General Provider Information

NPI Number : 1346310802
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TODD ALAN SUSSMAN MS, LMHC, LMFT
Provider Business Mailing Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-392-5689
Fax Number : 954-252-7134
Provider Business Practice Location Address
First Line : 19425 SW 58TH MNR
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33332-3338
Country : US
Telephone Number : 954-392-5689
Fax Number : 954-252-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 07/08/2007

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