Provider Demographics
NPI:1922665579
Name:RAUSEO-MAZZOCCA, ROSA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:
Last Name:RAUSEO-MAZZOCCA
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 1:4160 PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-5030
Mailing Address - Country:US
Mailing Address - Phone:954-805-5906
Mailing Address - Fax:
Practice Address - Street 1:4160 PINE RIDGE LN
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-5030
Practice Address - Country:US
Practice Address - Phone:954-805-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14841101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty