Provider Demographics
NPI:1669847208
Name:RAPHA COUNSELING, LLC
Entity Type:Organization
Organization Name:RAPHA COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEAN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:352-861-4481
Mailing Address - Street 1:1111 NE 25TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-5668
Mailing Address - Country:US
Mailing Address - Phone:352-861-4481
Mailing Address - Fax:352-292-3663
Practice Address - Street 1:1111 NE 25TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5675
Practice Address - Country:US
Practice Address - Phone:352-861-4481
Practice Address - Fax:352-292-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 002631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty