MS. SUSAN MAUREEN ARCHACKI-RESNIK (NPI# 1821258484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821258484 |
| Entity Type | Individual |
| Full Name | MS. SUSAN MAUREEN ARCHACKI-RESNIK |
| Credential | ARNP-FPMHNP-BC |
| Practice Address |
Lifestream Behavioral Center 2020 Tally Rd Leesburg FL 34749-1000 |
| Mailing Address |
2410 Ann Rou Rd Unit 106 Tavares FL 32778-5253 |
| Practice Telephone | 3523157800 |
| Mailing Telephone | 3866243284 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
ARNP1914742 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | CT364X | 01 |
| FL | 001788100 | 05 |
| Street Address |
LIFESTREAM BEHAVIORAL CENTER 2020 TALLY RD |
| City | LEESBURG |
| State | FL |
| Zip Code | 34749-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528669439 | Mary Nakbeen | Pharmacist | 41196 Canongate Dr, Leesburg, VA 20175-7072 | 2020-11-06 |
| 1174124952 | Timothy Joel Stansfield | Massage Therapist | 43845 Thornberry Sq Unit 403, Leesburg, VA 20176-3402 | 2020-11-06 |
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1174122717 | Art of Motion Physical Therapy LLC | Physical Therapist | 161 Fort Evans Rd Ne Ste 103, Leesburg, VA 20176-3369 | 2020-10-24 |
| 1023617206 | Favored Abilities Support Services LLC | In Home Supportive Care | 225 Crestrun Loop, Leesburg, FL 34748-2597 | 2020-10-20 |
| 1033718168 | Medihill Inc. | Durable Medical Equipment & Medical Supplies | 28229 County Road 33 Lot E6, Leesburg, FL 34748-4513 | 2020-10-20 |
| 1932707437 | Madison Dobscha | Specialist/Technologist | 1706 Revere Ct Ne, Leesburg, VA 20176-6634 | 2020-10-15 |
| 1174121941 | Patrick L Smith | Counselor | 117 Dove Ln, Leesburg, GA 31763-6211 | 2020-10-14 |
| 1558968875 | Veronica Winkler | Dietitian, Registered | 208 Birch St Ne, Leesburg, VA 20176-4524 | 2020-10-08 |
| 1306443684 | Montage Health and Wellness Corp | Family Medicine | 305 E Market St Ste O, Leesburg, VA 20176-4169 | 2020-10-08 |
| Find all providers in LEESBURG | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144464470 | April Christina Haukoos | Nurse Practitioner | 1017 W Dixie Ave, Leesburg, FL 34748-6309 | 2009-04-30 |
| 1821163940 | Linda D Stalters | Nurse Practitioner | 43490 Millwright Ter, Leesburg, VA 20176-8466 | 2006-11-22 |
| 1275622375 | Paula K Reilley | Nurse Practitioner | 104 E Dixie Ave, Leesburg, FL 34748-6350 | 2006-10-12 |
| 1952879439 | Mika Lyne Riley | Nurse Practitioner | 42009 Victory Ln, Leesburg, VA 20176-6269 | 2018-11-02 |
| 1689191017 | Yoneka Tahisha Powell | Nurse Practitioner | 104 E Dixie Ave, Leesburg, FL 34748-6350 | 2017-08-25 |
| 1770987570 | Maria Jeffries | Nurse Practitioner | 42009 Victory Ln, Leesburg, VA 20176-6269 | 2014-10-22 |
| 1679892616 | Kristie Johnson | Nurse Practitioner | 215 N 3rd St, Leesburg, FL 34748-5105 | 2010-05-28 |
| 1346261104 | Kathleen Jones-shupe | Nurse Practitioner | 101 S 11th St, Suite1, Leesburg, FL 34748-5767 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336832 | Marco Desouza | Nurse Practitioner | 10235 Avelar Ridge Dr, Riverview, FL 33578-7560 | 2020-11-02 |
| 1457950107 | Janet Rosemarie Walker | Nurse Practitioner | 9988 Sw 38th Ave, Ocala, FL 34476-4082 | 2020-10-23 |
| 1104425800 | Vijayalakshmi Kumaraguru | Nurse Practitioner | 102 Park Place Blvd Ste D1, Kissimmee, FL 34741-2358 | 2020-10-22 |
| 1356940217 | Smitha Ajesh | Nurse Practitioner | 9833 Westview Dr Apt 829, Coral Springs, FL 33076-2537 | 2020-10-21 |
| 1457959066 | Kecia Hicks | Nurse Practitioner | 691 Institution Rd, Defuniak Springs, FL 32433-1850 | 2020-10-15 |
| 1699372003 | Rosie Michel | Nurse Practitioner | 13000 Ne 12th Ave, North Miami, FL 33161-4305 | 2020-10-08 |
| 1952908352 | Karen Weinstock | Nurse Practitioner | 7148 Sportsmans Dr, North Lauderdale, FL 33068-5456 | 2020-10-08 |
| 1396342754 | Pamela Ziel | Nurse Practitioner | 545 Lakeside Cir, Sunrise, FL 33326-2136 | 2020-10-07 |
| 1922615608 | Urszula Dorfman | Nurse Practitioner | 1 Las Olas Cir Apt 609, Fort Lauderdale, FL 33316-1634 | 2020-09-28 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. SUSAN MAUREEN ARCHACKI-RESNIK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.