Provider Demographics
NPI:1881030757
Name:ZAGOROVA, MAGGIE (LMHC)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:ZAGOROVA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:
Other - Last Name:ZAGOROVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4211 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2014
Mailing Address - Country:US
Mailing Address - Phone:646-657-4131
Mailing Address - Fax:
Practice Address - Street 1:2400 E COMMERCIAL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4022
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16689101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health