Healthcare Provider Details

I. General information

NPI: 1932408432
Provider Name (Legal Business Name): MARK VINCENT ZAUSS LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2011
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 E OSCEOLA PKWY
KISSIMMEE FL
34744-1615
US

IV. Provider business mailing address

718 GARDEN PLZ
ORLANDO FL
32803-4212
US

V. Phone/Fax

Practice location:
  • Phone: 407-894-8894
  • Fax: 407-894-8893
Mailing address:
  • Phone: 407-894-8894
  • Fax: 407-894-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: