Provider Demographics
NPI:1194992701
Name:SIEGEL-JOFFE, RACHEL (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SIEGEL-JOFFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 KIPLING DR
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-2700
Mailing Address - Country:US
Mailing Address - Phone:917-916-9970
Mailing Address - Fax:
Practice Address - Street 1:18 KIPLING DR
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-2700
Practice Address - Country:US
Practice Address - Phone:917-916-9970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0765121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY059214OtherLMSW
NY03213816Medicaid
NY076512OtherLCSW