Healthcare Provider Details

I. General information

NPI: 1265786404
Provider Name (Legal Business Name): ELIZABETH VAH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH RUIZ-ZAMORA

II. Dates (important events)

Enumeration Date: 11/08/2012
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 VANDERBILT BEACH RD # 281
NAPLES FL
34109-2654
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US

V. Phone/Fax

Practice location:
  • Phone: 305-204-6651
  • Fax:
Mailing address:
  • Phone: 305-204-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number58.013564
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904013229
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number55614
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW10407
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-20846
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121186
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009007
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: