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General NPI Number Information
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NPI Number | 1730648841
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Entity Type | Individual
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Provider Name | HAKEEM B. RUFAI LMFT
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Gender | Male
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 04/08/2019
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Provider Practice Location Address
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Address Line | 1220 WILLIS AVE # 81
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2810
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Country | US
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Telephone | 773-336-2493
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SEABREEZE BLVD APT 509
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-4052
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Country | US
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Telephone | 773-336-2493
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MT3079
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MT3079
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3079
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License Number State | FL
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