Provider Demographics
NPI:1932461357
Name:PASHAK, EILEEN (MA)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:PASHAK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 CREEKSIDE DR STE D
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-4034
Mailing Address - Country:US
Mailing Address - Phone:727-593-0003
Mailing Address - Fax:727-596-1713
Practice Address - Street 1:4910 CREEKSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-4034
Practice Address - Country:US
Practice Address - Phone:727-593-0003
Practice Address - Fax:727-596-1713
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH9718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health