Provider Demographics
NPI:1558135244
Name:FITZPATRICK, PANAYIOTA (LMHC)
Entity Type:Individual
Prefix:
First Name:PANAYIOTA
Middle Name:
Last Name:FITZPATRICK
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 1:7130 SW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4254
Mailing Address - Country:US
Mailing Address - Phone:954-292-8362
Mailing Address - Fax:
Practice Address - Street 1:7130 SW 8TH CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4254
Practice Address - Country:US
Practice Address - Phone:954-292-8362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health