Provider Demographics
NPI:1700479433
Name:UGALDE, CARMEN RITA (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:CARMEN RITA
Middle Name:
Last Name:UGALDE
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2694 COCO PALM CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4029
Mailing Address - Country:US
Mailing Address - Phone:787-309-9838
Mailing Address - Fax:
Practice Address - Street 1:2694 COCO PALM CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4029
Practice Address - Country:US
Practice Address - Phone:787-309-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health