Provider Demographics
NPI:1407995574
Name:CHESTER, RACHEL R (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:R
Last Name:CHESTER
Suffix:
Gender:F
Credentials:PSYD
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 1393
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-0393
Mailing Address - Country:US
Mailing Address - Phone:541-606-9244
Mailing Address - Fax:
Practice Address - Street 1:105 LAKE HILL RD STE 10
Practice Address - Street 2:
Practice Address - City:BURNT HILLS
Practice Address - State:NY
Practice Address - Zip Code:12027-9596
Practice Address - Country:US
Practice Address - Phone:541-606-9244
Practice Address - Fax:888-223-9080
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024649103T00000X, 103TC0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No251S00000XAgenciesCommunity/Behavioral Health