Provider Demographics
NPI:1366730517
Name:AMATO, SUSAN MICHELLE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MICHELLE
Last Name:AMATO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:MICHELLE
Other - Last Name:DRENNAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC,LCPC
Mailing Address - Street 1:7040 SEMINOLE PRATT WHITNEY RD STE 25-171
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-5714
Mailing Address - Country:US
Mailing Address - Phone:855-738-3733
Mailing Address - Fax:
Practice Address - Street 1:7040 SEMINOLE PRATT WHITNEY RD STE 25-171
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-5714
Practice Address - Country:US
Practice Address - Phone:855-738-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MI6401012558101YP2500X
MDLC3242101YP2500X
FLMH11996101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor