Provider Demographics
NPI:1104977032
Name:ROCAFORT, WILMA (LMHC)
Entity type:Individual
Prefix:
First Name:WILMA
Middle Name:
Last Name:ROCAFORT
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 1:201 RUBY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5697
Mailing Address - Country:US
Mailing Address - Phone:407-518-9161
Mailing Address - Fax:407-518-9942
Practice Address - Street 1:201 RUBY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5697
Practice Address - Country:US
Practice Address - Phone:407-518-9161
Practice Address - Fax:407-518-9942
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 8768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ133HOtherBCBS
FLIN PROCESSMedicaid