Provider Demographics
NPI:1154057610
Name:ZEPHYRIN, AMANDA (LMHC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:ZEPHYRIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13840 OLD CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-3122
Mailing Address - Country:US
Mailing Address - Phone:727-656-2198
Mailing Address - Fax:
Practice Address - Street 1:4579 NORTHGATE CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2124
Practice Address - Country:US
Practice Address - Phone:941-366-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health