Provider Demographics
NPI:1073156121
Name:GROSSMAN, RACHEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 OCEAN PKWY APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3040
Mailing Address - Country:US
Mailing Address - Phone:347-909-8203
Mailing Address - Fax:
Practice Address - Street 1:1860 OCEAN PKWY APT 4A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3040
Practice Address - Country:US
Practice Address - Phone:347-909-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1034371041C0700X
NY0906871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical