Healthcare Provider Details

I. General information

NPI: 1881030757
Provider Name (Legal Business Name): MAGGIE ZAGOROVA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAGDALENA ZAGOROVA

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E COMMERCIAL BLVD STE 101
FORT LAUDERDALE FL
33308-4022
US

IV. Provider business mailing address

4211 NW 22ND ST
COCONUT CREEK FL
33066-2014
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 646-657-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH16689
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: