Provider Demographics
NPI:1831759513
Name:BRANIGAN, ROXANA (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:BRANIGAN
Suffix:
Gender:
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SW 12TH TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8432
Mailing Address - Country:US
Mailing Address - Phone:310-220-3122
Mailing Address - Fax:
Practice Address - Street 1:7100 CAMINO REAL STE 404
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5510
Practice Address - Country:US
Practice Address - Phone:561-221-2726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2025-04-17
Deactivation Date:2019-07-28
Deactivation Code:
Reactivation Date:2019-09-25
Provider Licenses
StateLicense IDTaxonomies
FLMH17021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health