Provider Demographics
NPI:1730717877
Name:ZHAO, SISI (LMHC, NCC, CRC, MA)
Entity type:Individual
Prefix:
First Name:SISI
Middle Name:
Last Name:ZHAO
Suffix:
Gender:F
Credentials:LMHC, NCC, CRC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 RINGLING BLVD UNIT 812
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-6869
Mailing Address - Country:US
Mailing Address - Phone:941-323-8873
Mailing Address - Fax:
Practice Address - Street 1:2856 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2410
Practice Address - Country:US
Practice Address - Phone:941-323-8873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH17912OtherSTATE LICENSE