Provider Demographics
NPI:1285076745
Name:MAHEU, RACHELE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:RACHELE
Middle Name:
Last Name:MAHEU
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 LA FEIL DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63021-7011
Mailing Address - Country:US
Mailing Address - Phone:314-325-4132
Mailing Address - Fax:314-332-2503
Practice Address - Street 1:8780 BIG BEND BLVD STE B
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-3774
Practice Address - Country:US
Practice Address - Phone:314-325-4132
Practice Address - Fax:314-332-2503
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0209691041C0700X
MO20190102851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1285076745Medicaid