Provider Demographics
NPI:1780296418
Name:ESFORMES, MINTHA SHEFFIELD (LMFT)
Entity type:Individual
Prefix:
First Name:MINTHA
Middle Name:SHEFFIELD
Last Name:ESFORMES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:MINTHA
Other - Middle Name:PATRICIA MAE
Other - Last Name:SHEFFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:7207 TEAL CREEK GLN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-5037
Mailing Address - Country:US
Mailing Address - Phone:520-818-4934
Mailing Address - Fax:
Practice Address - Street 1:7207 TEAL CREEK GLN
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5037
Practice Address - Country:US
Practice Address - Phone:520-818-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA119260106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty