Provider Demographics
NPI:1003914979
Name:MCGHEE, RAECHEL ANNE (LICSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:RAECHEL
Middle Name:ANNE
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:LICSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:4 HARTWELL ST
Practice Address - Street 2:SUITE 306
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3019
Practice Address - Country:US
Practice Address - Phone:508-677-2399
Practice Address - Fax:508-678-3300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10321391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22262Medicare ID - Type Unspecified