Provider Demographics
NPI:1033867585
Name:WEINTRAUB, RACHEL (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SETTLERS WAY
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3651
Mailing Address - Country:US
Mailing Address - Phone:860-604-1142
Mailing Address - Fax:
Practice Address - Street 1:880 BURBANK AVE
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-1459
Practice Address - Country:US
Practice Address - Phone:860-758-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5954101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional