Provider Demographics
NPI:1689388951
Name:ZAMOR, STANLEY (LMHC-INTERN)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:ZAMOR
Suffix:
Gender:M
Credentials:LMHC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 ANTICA ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-1503
Mailing Address - Country:US
Mailing Address - Phone:239-288-1037
Mailing Address - Fax:
Practice Address - Street 1:3257 ANTICA ST
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-1503
Practice Address - Country:US
Practice Address - Phone:239-288-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty