Provider Demographics
NPI:1477872968
Name:HENNESSY, RACHEL ALETHEA (MSW, ITDS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALETHEA
Last Name:HENNESSY
Suffix:
Gender:F
Credentials:MSW, ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 PINELLAS POINT DR S APT 198
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-6726
Mailing Address - Country:US
Mailing Address - Phone:773-817-8044
Mailing Address - Fax:
Practice Address - Street 1:501 6TH AVE S DEPT 6005
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4634
Practice Address - Country:US
Practice Address - Phone:727-767-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-23
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker