Healthcare Provider Details

I. General information

NPI: 1225705940
Provider Name (Legal Business Name): COURTNEY E DEL ROSARIO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date: 03/19/2024
Reactivation Date: 03/26/2024

III. Provider practice location address

266 CRYSTAL GROVE BLVD
LUTZ FL
33548-6460
US

IV. Provider business mailing address

266 CRYSTAL GROVE BLVD
LUTZ FL
33548-6460
US

V. Phone/Fax

Practice location:
  • Phone: 609-549-1175
  • Fax:
Mailing address:
  • Phone: 813-575-0931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: