Provider Demographics
NPI:1326180928
Name:SMITH, RACHAEL ELIZABETH (RN MA CRC LCMHC)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN MA CRC LCMHC
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 STATION ST
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-5771
Mailing Address - Country:US
Mailing Address - Phone:401-828-5065
Mailing Address - Fax:
Practice Address - Street 1:81 STATION ST
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-5771
Practice Address - Country:US
Practice Address - Phone:401-828-5065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00092101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor