Provider Demographics
NPI:1215623046
Name:JAWORSKI, RACHEL L (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:JAWORSKI
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 1:331 GRIS SKY LN
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-3605
Mailing Address - Country:US
Mailing Address - Phone:609-230-2433
Mailing Address - Fax:
Practice Address - Street 1:5157 PARK CLUB DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-1801
Practice Address - Country:US
Practice Address - Phone:845-540-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL166781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical