Provider Demographics
NPI:1922694876
Name:CAVUCCI, RACHEL (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:CAVUCCI
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2503 DEL PRADO BLVD S STE 410
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5709
Mailing Address - Country:US
Mailing Address - Phone:321-578-8550
Mailing Address - Fax:239-242-6389
Practice Address - Street 1:2503 DEL PRADO BLVD S STE 410A
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5709
Practice Address - Country:US
Practice Address - Phone:638-523-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20181101YM0800X
FLMH21358101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health