Provider Demographics
NPI:1356303804
Name:STEPHENSON, RACHEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:STEPHENSON
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:PO BOX 667
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:ME
Mailing Address - Zip Code:04951-0667
Mailing Address - Country:US
Mailing Address - Phone:207-525-4445
Mailing Address - Fax:
Practice Address - Street 1:18 TOWN HOUSE RD
Practice Address - Street 2:
Practice Address - City:SWANVILLE
Practice Address - State:ME
Practice Address - Zip Code:04915-4528
Practice Address - Country:US
Practice Address - Phone:207-944-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC37421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical