Provider Demographics
NPI:1821704230
Name:TAFT, REBECCA (LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TAFT
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 1:171 OAKWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-6040
Mailing Address - Country:US
Mailing Address - Phone:407-257-4491
Mailing Address - Fax:
Practice Address - Street 1:3222 CORRINE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2217
Practice Address - Country:US
Practice Address - Phone:407-257-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH21741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health