Provider Demographics
NPI:1891829933
Name:ZAPATHA, SUSAN PAGE (LMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PAGE
Last Name:ZAPATHA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:P
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 CLARK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8435
Mailing Address - Country:US
Mailing Address - Phone:941-888-2081
Mailing Address - Fax:888-700-6760
Practice Address - Street 1:3333 CLARK RD STE 170
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8435
Practice Address - Country:US
Practice Address - Phone:941-888-2081
Practice Address - Fax:888-700-6760
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016915000Medicaid