Provider Demographics
NPI:1417001561
Name:VLASTARAS, PETER (LMHC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:VLASTARAS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7809 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3028
Mailing Address - Country:US
Mailing Address - Phone:727-841-4200
Mailing Address - Fax:727-816-1222
Practice Address - Street 1:8005 KING HELIE BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-1436
Practice Address - Country:US
Practice Address - Phone:727-841-4200
Practice Address - Fax:727-816-1222
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health