Provider Demographics
NPI:1467697151
Name:JAMES, RAFAEL (LCSW)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:JAMES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SAXONY E
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1844
Mailing Address - Country:US
Mailing Address - Phone:858-282-6117
Mailing Address - Fax:
Practice Address - Street 1:500 LA TERRAZA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3876
Practice Address - Country:US
Practice Address - Phone:858-282-6117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70535101YM0800X
NYR04053411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR040534-01OtherTHE UNIVERSITY OF THE STATE OF NY EDUCATION DEPARTMENT OFFICE OF PROFESSIONS
FLSW21387OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE