Provider Demographics
NPI:1962734525
Name:SPOSATO, HEIDI YOLANDA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:YOLANDA
Last Name:SPOSATO
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 KEATON PKWY
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4302
Mailing Address - Country:US
Mailing Address - Phone:321-222-7107
Mailing Address - Fax:321-286-7844
Practice Address - Street 1:732 KEATON PKWY
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4302
Practice Address - Country:US
Practice Address - Phone:321-222-7107
Practice Address - Fax:321-286-7844
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP2500X
FLMT 3010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional