Provider Demographics
NPI:1407284359
Name:RABIN, MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RABIN
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 26422
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-6422
Mailing Address - Country:US
Mailing Address - Phone:559-313-2075
Mailing Address - Fax:559-228-8329
Practice Address - Street 1:2501 W SHAW AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3307
Practice Address - Country:US
Practice Address - Phone:559-313-2075
Practice Address - Fax:559-228-8329
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS212951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical