Provider Demographics
NPI:1194547273
Name:D'AMICO, RASHELLA MCBETH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:RASHELLA
Middle Name:MCBETH
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:MRS
Other - First Name:RASHELLA
Other - Middle Name:ANN
Other - Last Name:MCBETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RBC, CAMS-II
Mailing Address - Street 1:912 E LASALLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2817
Mailing Address - Country:US
Mailing Address - Phone:574-231-8000
Mailing Address - Fax:
Practice Address - Street 1:912 E LASALLE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2817
Practice Address - Country:US
Practice Address - Phone:574-231-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IN103TM1800X, 101YM0800X, 102L00000X
TX101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst