Susan Conyac, LMHC
Individual provider Active NPI Mental Health Counselor · Debary, FL
NPI 1073859468 · NPPES record last updated Feb 24, 2021
Key facts
- NPI
- 1073859468
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 18854 (FL)
- Practice address
- 140 Bradwick Cir
Debary, FL 32713-2117 - Phone
- (386) 717-9612
- NPI assigned
- Dec 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18854 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Counselor | Current | Accepting new patients |
| Growing Hope Therapy, LLC | Mental Health | Current |
Accepting new patients |
Interoperability endpoints
- susanconyac@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 18854 | FL | Yes |
Addresses
Primary practice location
140 Bradwick Cir
Debary, FL 32713-2117
Mailing address
140 Bradwick Cir
Debary, FL 32713-2117
Phone (386) 717-9612
Other providers in Debary, FL
- Tyrone Cherry
- Kylah Cheyanne Collins
- Myrna Colon
- Contemporary Pilates & Massage, Inc
- Carlos Enrique Contreras Benitez
- John X Cordoba
- Crown Medical Transport LLC
- Nayaris Cruz
- Antonio Miguel Cubano
- Ashlynn Da Silva
All providers in Debary, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.