Provider Demographics
NPI:1306624820
Name:DIBELLA, RACHEL ANNE (LICSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:DIBELLA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3722
Mailing Address - Country:US
Mailing Address - Phone:508-245-8816
Mailing Address - Fax:
Practice Address - Street 1:745 GROVE ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3722
Practice Address - Country:US
Practice Address - Phone:508-245-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1209231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical