Provider Demographics
NPI:1477576742
Name:THORPE, RACHEL L (LICSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:L
Last Name:THORPE
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4167 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2403
Mailing Address - Country:US
Mailing Address - Phone:941-219-3111
Mailing Address - Fax:941-894-1322
Practice Address - Street 1:4167 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2403
Practice Address - Country:US
Practice Address - Phone:941-219-3111
Practice Address - Fax:941-894-1322
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW00714104100000X
FLSW103791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ03F4OtherBC/BS OF FLORIDA
FL275242405OtherHUMANA MILITARY
RI216490OtherBLUE CROSS BLUE SHIELD
RI6272525OtherUNITED HEALTHCARE
RI6272525OtherUNITED HEALTHCARE