Provider Demographics
NPI:1154780377
Name:GILBERT, RACHEL ANNE (MS)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 MEADOW ST
Mailing Address - Street 2:SUITE 001
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:228 MEADOW ST
Practice Address - Street 2:SUITE 001
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1807
Practice Address - Country:US
Practice Address - Phone:203-437-8896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008042640Medicaid