Provider Demographics
NPI:1023396587
Name:COLAVITO, RACHEL H (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:H
Last Name:COLAVITO
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:HIRST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9942 STOCKBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1842
Mailing Address - Country:US
Mailing Address - Phone:386-299-9736
Mailing Address - Fax:
Practice Address - Street 1:4595 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2058
Practice Address - Country:US
Practice Address - Phone:904-783-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT 1557106H00000X
FL2865106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist