Provider Demographics
NPI:1053889881
Name:FURTADO, BAMBI (LMHC)
Entity type:Individual
Prefix:
First Name:BAMBI
Middle Name:
Last Name:FURTADO
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 1:2688 FRUITVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5223
Mailing Address - Country:US
Mailing Address - Phone:941-366-2224
Mailing Address - Fax:941-366-2982
Practice Address - Street 1:2688 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5223
Practice Address - Country:US
Practice Address - Phone:941-366-2224
Practice Address - Fax:941-366-2982
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12817101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health