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1942855580

NPI Code Detail

MEDICARE: SUSAN LEE BOBROW LGPC, NCC, RMHCI

MEDICARE: SUSAN LEE BOBROW LGPC, NCC, RMHCI

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	101YM0800X	Mental Health Counselor	LGP9610	MD

General Provider Information

NPI Number	:	1942855580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN LEE BOBROW LGPC, NCC, RMHCI

Provider Business Mailing Address
First Line	:	2020 PAINTED PALM DR
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3372
Country	:	US
Telephone Number	:	443-617-0711
Fax Number	:

Provider Business Practice Location Address
First Line	:	3049 CLEVELAND AVE STE 295
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-7054
Country	:	US
Telephone Number	:	813-754-5555
Fax Number	:

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

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	08/08/2019

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Directions to “ SUSAN LEE BOBROW LGPC, NCC, RMHCI” Practice Location

Language	Start Address	Practice Location

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