Rita, Jacqueline

Rita, Jacqueline is an sole proprietor health care provider with primary practice located at 211 E International Speedway Blvd Ste 107 , Daytona Beach FL 32118-4662. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Rita, Jacqueline can be contacted via phone (401) 486-6081.

Contact Information

Primary practice address
211 E International Speedway Blvd Ste 107 Daytona Beach FL 32118-4662
Phone: (401) 486-6081
Fax: (386) 401-2414
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 11788 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 00222 Rhode Island

Profile Details

NPI number 1598740896
LBN Legal business name Rita, Jacqueline
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2005
Last updated Mar 3rd, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598740896 NPPES
Rhode Island Other 27972-1 BLUE CROSS
Rhode Island Other 412090 BLUE CROSS
Rhode Island MEDICAID JR36967 BLUE CROSS

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