Provider Demographics
NPI:1053566679
Name:SUKENIK, MICHELLE BETH (PSYD, LMHC, NCC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BETH
Last Name:SUKENIK
Suffix:
Gender:F
Credentials:PSYD, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 CENTRAL PARK BLVD N
Mailing Address - Street 2:SUITE 235
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1759
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9960 CENTRAL PARK BLVD N
Practice Address - Street 2:SUITE 235
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-1759
Practice Address - Country:US
Practice Address - Phone:561-483-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNCC #263011101YM0800X
FLLMHC #MH8300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health