Provider Demographics
NPI:1053456442
Name:MARSTON, RACHEL C
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:MARSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 ADAMSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLRAIN
Mailing Address - State:MA
Mailing Address - Zip Code:01340-9739
Mailing Address - Country:US
Mailing Address - Phone:413-768-7210
Mailing Address - Fax:
Practice Address - Street 1:303 ADAMSVILLE RD
Practice Address - Street 2:
Practice Address - City:COLRAIN
Practice Address - State:MA
Practice Address - Zip Code:01340-9739
Practice Address - Country:US
Practice Address - Phone:413-767-7210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MA2142151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000887102Medicare PIN