Provider Demographics
NPI:1508322470
Name:SUZETTE CASABIANCA LMFT
Entity Type:Organization
Organization Name:SUZETTE CASABIANCA LMFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASABIANCA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:727-597-3303
Mailing Address - Street 1:PO BOX 883
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34673-0883
Mailing Address - Country:US
Mailing Address - Phone:727-597-3303
Mailing Address - Fax:727-754-4230
Practice Address - Street 1:2708 ALT 19 STE 507-10
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-2665
Practice Address - Country:US
Practice Address - Phone:727-597-3303
Practice Address - Fax:727-754-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty