Provider Demographics
NPI:1790147643
Name:ZOFFINGER, CAROL (LMHC; CAP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ZOFFINGER
Suffix:
Gender:F
Credentials:LMHC; CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1836 N CRYSTAL LAKE DR APT 56
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-6587
Mailing Address - Country:US
Mailing Address - Phone:813-719-5141
Mailing Address - Fax:863-644-9025
Practice Address - Street 1:6700 S FLORIDA AVE
Practice Address - Street 2:SUITE 29
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3327
Practice Address - Country:US
Practice Address - Phone:863-644-8241
Practice Address - Fax:863-644-9025
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 5485101YA0400X
FLMH13002101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)