Provider Demographics
NPI:1437866407
Name:RAKSIN, SHULAMIS R (LMHC)
Entity type:Individual
Prefix:
First Name:SHULAMIS
Middle Name:R
Last Name:RAKSIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 NW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8235
Mailing Address - Country:US
Mailing Address - Phone:305-218-7474
Mailing Address - Fax:
Practice Address - Street 1:621 NW 53RD ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-8235
Practice Address - Country:US
Practice Address - Phone:305-968-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health