Provider Demographics
NPI:1235411315
Name:DISTLER, RACHEL E (LMHC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:E
Last Name:DISTLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 CEDAR ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-5527
Mailing Address - Country:US
Mailing Address - Phone:617-501-9459
Mailing Address - Fax:
Practice Address - Street 1:53 CHESTER ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-3001
Practice Address - Country:US
Practice Address - Phone:617-221-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health