Provider Demographics
NPI:1548788466
Name:RESNIK, SUSAN A (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:A
Last Name:RESNIK
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 1:570 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-2432
Mailing Address - Country:US
Mailing Address - Phone:786-651-4198
Mailing Address - Fax:
Practice Address - Street 1:4308 ALTON RD STE 420
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4557
Practice Address - Country:US
Practice Address - Phone:786-651-4198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health