Provider Demographics
NPI:1487857512
Name:SAROS, JEANNIE (LMHC)
Entity Type:Individual
Prefix:
First Name:JEANNIE
Middle Name:
Last Name:SAROS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JEANNIE
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, CAP
Mailing Address - Street 1:6699 N FEDERAL HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1660
Mailing Address - Country:US
Mailing Address - Phone:561-542-0941
Mailing Address - Fax:561-734-6844
Practice Address - Street 1:6699 N FEDERAL HWY
Practice Address - Street 2:STE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1660
Practice Address - Country:US
Practice Address - Phone:561-542-0941
Practice Address - Fax:561-734-6844
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8070101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor