Provider Demographics
NPI:1346746047
Name:STANSU, ESTHER AGATA (LMHC)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:AGATA
Last Name:STANSU
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 1:2085 CAVALLA RD
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2860
Mailing Address - Country:US
Mailing Address - Phone:305-206-1183
Mailing Address - Fax:
Practice Address - Street 1:755 27TH AVE SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-4200
Practice Address - Country:US
Practice Address - Phone:305-206-1183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health