Provider Demographics
NPI:1144990078
Name:STADTLANDER, ELIZABETH SUSAN (LMFT, MHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUSAN
Last Name:STADTLANDER
Suffix:
Gender:F
Credentials:LMFT, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19578 E COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4831
Mailing Address - Country:US
Mailing Address - Phone:412-376-7322
Mailing Address - Fax:
Practice Address - Street 1:19578 E COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-4831
Practice Address - Country:US
Practice Address - Phone:412-376-7322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty