Healthcare Provider Details

I. General information

NPI: 1295847721
Provider Name (Legal Business Name): LYNN SUZANNE ZAGOREN PSY.D., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NW 53RD ST
BOCA RATON FL
33487-3748
US

IV. Provider business mailing address

301 NW 53RD ST
BOCA RATON FL
33487-3748
US

V. Phone/Fax

Practice location:
  • Phone: 561-542-5600
  • Fax:
Mailing address:
  • Phone: 561-542-5600
  • Fax: 561-542-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH3861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: