Provider Demographics
NPI:1588712228
Name:MAITH, RICK (LCSW)
Entity type:Individual
Prefix:PROF
First Name:RICK
Middle Name:
Last Name:MAITH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 ALMOND TREE CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6645 VINELAND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7841
Practice Address - Country:US
Practice Address - Phone:407-363-6779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 20421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical