Provider Demographics
NPI:1306033527
Name:SUZANNE STONBELY PHD LCSW PA
Entity Type:Organization
Organization Name:SUZANNE STONBELY PHD LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STONBELY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-604-8933
Mailing Address - Street 1:1000 LINCOLN RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2500
Mailing Address - Country:US
Mailing Address - Phone:305-604-8933
Mailing Address - Fax:305-604-8929
Practice Address - Street 1:1000 LINCOLN RD
Practice Address - Street 2:SUITE 225
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2500
Practice Address - Country:US
Practice Address - Phone:305-604-8933
Practice Address - Fax:305-604-8929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW0003450261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH321Medicare PIN