Provider Demographics
NPI:1407806045
Name:ROSEN, RACHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:DINKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 N CRAIG STREET
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-687-8700
Mailing Address - Fax:412-687-6808
Practice Address - Street 1:155 N CRAIG STREET
Practice Address - Street 2:SUITE 170
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-687-8700
Practice Address - Fax:412-687-6808
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW001050L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA462903OtherVALUE OPTIONS
PA642823Medicare ID - Type Unspecified
S39312Medicare UPIN