Provider Demographics
NPI:1346856325
Name:TARATUTA, BENJAMIN (LMHC, NCC, CAMS-II)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:TARATUTA
Suffix:
Gender:M
Credentials:LMHC, NCC, CAMS-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N FEDERAL HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5180
Mailing Address - Country:US
Mailing Address - Phone:561-871-0153
Mailing Address - Fax:
Practice Address - Street 1:4400 N FEDERAL HWY STE 200
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5180
Practice Address - Country:US
Practice Address - Phone:561-871-0153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health