Provider Demographics
NPI:1982445060
Name:BROWN, RACHEL (LMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:195 WILDACRE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1414
Mailing Address - Country:US
Mailing Address - Phone:647-771-5546
Mailing Address - Fax:
Practice Address - Street 1:1216 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4483
Practice Address - Country:US
Practice Address - Phone:646-688-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117691104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker