Provider Demographics
NPI:1073369716
Name:CHACE, RACHEL MARIE (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:CHACE
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:CHACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RACHEL RESNICK, LMSW
Mailing Address - Street 1:99 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:CT
Mailing Address - Zip Code:06524-3246
Mailing Address - Country:US
Mailing Address - Phone:475-455-1423
Mailing Address - Fax:
Practice Address - Street 1:99 MILLER RD
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:CT
Practice Address - Zip Code:06524-3246
Practice Address - Country:US
Practice Address - Phone:475-455-1423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9593104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker