Provider Demographics
NPI:1124198460
Name:MARGOLIN, RACHEL BRAND (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BRAND
Last Name:MARGOLIN
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 1:110 MARTER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3124
Mailing Address - Country:US
Mailing Address - Phone:856-778-4330
Mailing Address - Fax:856-778-4408
Practice Address - Street 1:110 MARTER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3124
Practice Address - Country:US
Practice Address - Phone:856-778-4330
Practice Address - Fax:856-778-4408
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053485001041C0700X
NYR051326-11041C0700X
MA1132801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1215470174Medicaid