Provider Demographics
NPI:1598002743
Name:ACOSTA, ANA CLARIBEL (MFT)
Entity Type:Individual
Prefix:MISS
First Name:ANA
Middle Name:CLARIBEL
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 SW PALM DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1944
Mailing Address - Country:US
Mailing Address - Phone:561-536-8178
Mailing Address - Fax:772-257-5265
Practice Address - Street 1:1945 22ND AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3083
Practice Address - Country:US
Practice Address - Phone:772-257-5264
Practice Address - Fax:772-257-5265
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor