Provider Demographics
NPI:1861167447
Name:CETTA, SUSANA ROCIO (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SUSANA
Middle Name:ROCIO
Last Name:CETTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 SW 176TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6242
Mailing Address - Country:US
Mailing Address - Phone:786-999-4669
Mailing Address - Fax:
Practice Address - Street 1:7900 SW 176TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6242
Practice Address - Country:US
Practice Address - Phone:786-999-4669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-15
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH5096OtherFLORIDAY DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION