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General NPI Number Information
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NPI Number | 1669847208
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Entity Type | Organization
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Legal Business Name | RAPHA COUNSELING, LLC
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Dates
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Enumeration Date | 12/08/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 1111 NE 25TH AVE SUITE 402
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City | OCALA
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State | FL
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Zip | 34470-5675
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Country | US
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Telephone | 352-861-4481
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Fax | 352-292-3663
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Provider Business Mailing Address
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Address Line | 1111 NE 25TH AVE SUITE 402
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City | OCALA
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State | FL
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Zip | 34470-5668
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Country | US
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Telephone | 352-861-4481
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Fax | 352-292-3663
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Authorized Official
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Title or Position | CO-OWNER/PSYCHOTHERAPIST
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Name | MR. MICHAEL KEAN WEAVER
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Credential | L.M.H.C.
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Telephone | 352-861-4481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 002631
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License Number State | FL
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