Provider Demographics
NPI:1023606407
Name:KONSTANTOPOULOS, KATERINA (LMHC)
Entity type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:KONSTANTOPOULOS
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 1:9880 SW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2301
Mailing Address - Country:US
Mailing Address - Phone:954-303-1778
Mailing Address - Fax:
Practice Address - Street 1:9880 SW 1ST CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2301
Practice Address - Country:US
Practice Address - Phone:954-303-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH16274Medicaid