Provider Demographics
NPI:1164839551
Name:EFFMAN, AMY SUZANNE (LMFT, CAP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUZANNE
Last Name:EFFMAN
Suffix:
Gender:F
Credentials:LMFT, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PLAZA REAL S STE 226
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4865
Mailing Address - Country:US
Mailing Address - Phone:561-699-8896
Mailing Address - Fax:
Practice Address - Street 1:101 PLAZA REAL S STE 226
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4865
Practice Address - Country:US
Practice Address - Phone:561-699-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4955101YA0400X
FLMT2753106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)