Healthcare Provider Details
I. General information
NPI: 1891829933
Provider Name (Legal Business Name): SUSAN PAGE ZAPATHA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 CLARK RD STE 170
SARASOTA FL
34231-8435
US
IV. Provider business mailing address
3333 CLARK RD STE 170
SARASOTA FL
34231-8435
US
V. Phone/Fax
- Phone: 941-888-2081
- Fax: 888-700-6760
- Phone: 941-888-2081
- Fax: 888-700-6760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH 7032 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: