Provider Demographics
NPI:1962822247
Name:CONCEPCION, RAQUEL F (LMHC)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:F
Last Name:CONCEPCION
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 1:5545 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2274
Mailing Address - Country:US
Mailing Address - Phone:306-791-7935
Mailing Address - Fax:
Practice Address - Street 1:5545 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2274
Practice Address - Country:US
Practice Address - Phone:306-791-7935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health