Provider Demographics
NPI:1992832158
Name:FEDOR, DONALD ERNEST (MS LMHC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:ERNEST
Last Name:FEDOR
Suffix:
Gender:M
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3565 E SUZIE LANE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-3250
Mailing Address - Country:US
Mailing Address - Phone:352-344-4497
Mailing Address - Fax:352-344-4497
Practice Address - Street 1:3565 E SUZIE LANE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-3250
Practice Address - Country:US
Practice Address - Phone:352-344-4497
Practice Address - Fax:352-344-4497
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1365101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health