Provider Demographics
NPI:1396092094
Name:REXACH, CLAUDIA (PSYD, LMHC)
Entity type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:
Last Name:REXACH
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 S LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4626
Mailing Address - Country:US
Mailing Address - Phone:787-354-5540
Mailing Address - Fax:
Practice Address - Street 1:1375 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8304
Practice Address - Country:US
Practice Address - Phone:561-424-7013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042622756OtherCOMMONWEALTH CARE
MA8443OtherBMC
MA997303OtherNETWORK HEALTH
MA1022610OtherBEACON
MA1303295OtherMBHP