Provider Demographics
NPI:1801640214
Name:RAO, CAROL AMANDA
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:AMANDA
Last Name:RAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 ROWAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-5609
Mailing Address - Country:US
Mailing Address - Phone:352-678-5550
Mailing Address - Fax:352-678-5551
Practice Address - Street 1:17222 HOSPITAL BLVD STE 120
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8906
Practice Address - Country:US
Practice Address - Phone:352-678-5550
Practice Address - Fax:352-678-5551
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health