Provider Demographics
NPI:1124400437
Name:SUMPF, ELIZABETH P (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:P
Last Name:SUMPF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 N OCEAN DRIVE
Mailing Address - Street 2:#184
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2920
Mailing Address - Country:US
Mailing Address - Phone:954-540-4579
Mailing Address - Fax:866-757-5778
Practice Address - Street 1:2300 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33306
Practice Address - Country:US
Practice Address - Phone:954-540-4579
Practice Address - Fax:866-757-5778
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW124951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical