Provider Demographics
NPI:1508029059
Name:CARRASCO, RUTH MERY (LMHC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:MERY
Last Name:CARRASCO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 SW 75TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2782
Mailing Address - Country:US
Mailing Address - Phone:786-201-2768
Mailing Address - Fax:
Practice Address - Street 1:9370 SUNSET DR STE A213
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:786-528-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8531101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH8531OtherFLORIDA DEPARTMENT OF HEALTH