Healthcare Provider Details

I. General information

NPI: 1013784388
Provider Name (Legal Business Name): SYDNEY RAFAEL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 S MILITARY TRL STE 208
DELRAY BEACH FL
33484-2654
US

IV. Provider business mailing address

14000 S MILITARY TRL STE 208
DELRAY BEACH FL
33484-2654
US

V. Phone/Fax

Practice location:
  • Phone: 561-563-7110
  • Fax: 561-563-7111
Mailing address:
  • Phone: 561-563-7110
  • Fax: 561-563-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28113
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: