Provider Demographics
NPI:1386849073
Name:FERRADAS, SUSANA J (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:J
Last Name:FERRADAS
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 1:1150 103RD ST
Mailing Address - Street 2:#21
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3709
Mailing Address - Country:US
Mailing Address - Phone:305-205-2898
Mailing Address - Fax:
Practice Address - Street 1:1550 MADRUGA AVE
Practice Address - Street 2:SUITE 406
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3039
Practice Address - Country:US
Practice Address - Phone:305-205-2898
Practice Address - Fax:305-740-8103
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health