MEDICARE: KATHERINE SEVASTY HATZITHEODOROU LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MT3204	FL
2	101YM0800X	Mental Health Counselor
3	106H00000X	Marriage & Family Therapist	MT3204

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851863666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE SEVASTY HATZITHEODOROU LMFT

Provider Business Mailing Address
First Line	:	4776 NEW BROAD ST STE 201
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6423
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:

Provider Business Practice Location Address
First Line	:	4776 NEW BROAD ST STE 201
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6423
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2018
Last Update Date	:	12/18/2025

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Directions to “ KATHERINE SEVASTY HATZITHEODOROU LMFT” Practice Location

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