Provider Demographics
NPI:1306327440
Name:RACHEL LEONARD LICSW, INC
Entity type:Organization
Organization Name:RACHEL LEONARD LICSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-316-0126
Mailing Address - Street 1:PO BOX 574
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-0010
Mailing Address - Country:US
Mailing Address - Phone:401-316-0126
Mailing Address - Fax:401-223-6883
Practice Address - Street 1:650 TEN ROD RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4238
Practice Address - Country:US
Practice Address - Phone:401-316-0126
Practice Address - Fax:401-223-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty