Provider Demographics
NPI:1336304872
Name:LAFEHR BOLLINGER, SUSAN (PHD, FAACS, LMHC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:LAFEHR BOLLINGER
Suffix:
Gender:F
Credentials:PHD, FAACS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6274
Mailing Address - Country:US
Mailing Address - Phone:561-630-2747
Mailing Address - Fax:561-630-2707
Practice Address - Street 1:4360 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6274
Practice Address - Country:US
Practice Address - Phone:561-630-2747
Practice Address - Fax:561-630-2707
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health