Raina Burlak PA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14350 Issued in FL

Legal business name

RAINA BURLAK PA

Practice address

12553 New Brittany Blvd Ste 32
Fort Myers, FL 33907-3625

Phone

(239) 689-3079

Fax

(239) 313-6923

NPI assigned

Oct 31, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raina Rainbow Burlak, LMHC NCCNPI 1811352107

Title

President

Phone

(239) 821-9754

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raina Burlak, MS NCC

  • Mental Health Counselor
  • Fort Myers, FL
  • NPI 1811352107
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1356853311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12553 NEW BRITTANY BOULEVARD",
            "address_2": "SUITE 32",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33907",
            "telephone_number": "239-689-3079",
            "fax_number": "239-313-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12553 NEW BRITTANY BLVD STE 32",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073625",
            "telephone_number": "239-689-3079",
            "fax_number": "239-313-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINA BURLAK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "BURLAK",
        "authorized_official_first_name": "RAINA",
        "authorized_official_middle_name": "RAINBOW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-821-9754",
        "authorized_official_credential": "LMHC NCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahrim Rahman, O.D.
• Bobak Reza Rahmanian, DO
• Ragini M Rai
• Tresa Rai, MSGC
• Andrew Lee Raider, D.O.
• Roxanne Raiola, PA-C
• Cyrus Alexander Rais, MD
• Nikhil Vijay Rajadhyaksha, M.D.
• Adikkan Oanthan Rajagopal, MD
• Rajan Sareen MD PLLC

• Mental Health Counselor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.