Provider Demographics
NPI:1649034935
Name:HAUGHTON, NATASHA (RMHCI)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HAUGHTON
Suffix:
Gender:
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 S ORLANDO AVE STE E
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6471
Mailing Address - Country:US
Mailing Address - Phone:407-619-0994
Mailing Address - Fax:
Practice Address - Street 1:1515 S ORLANDO AVE STE E
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6471
Practice Address - Country:US
Practice Address - Phone:407-603-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26804101YM0800X
FLCBHCMS.0102722171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL124652000Medicaid
FLCBHCMS.0102722OtherFLORIDA CERTIFICATION BOARD