Provider Demographics
NPI:1386013100
Name:FLORENCE, RAVEEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RAVEEN
Middle Name:
Last Name:FLORENCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 LYDIA CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-1741
Mailing Address - Country:US
Mailing Address - Phone:813-451-4359
Mailing Address - Fax:
Practice Address - Street 1:1857 NADINE RD
Practice Address - Street 2:APT 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4934
Practice Address - Country:US
Practice Address - Phone:813-451-4359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW146111041C0700X
FLISW9494104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker