Provider Demographics
NPI:1508231713
Name:RACHEL HUMMEL-SASS, PSY.D., LLC
Entity Type:Organization
Organization Name:RACHEL HUMMEL-SASS, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMMEL-SASS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:419-455-6891
Mailing Address - Street 1:PO BOX 954
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-0954
Mailing Address - Country:US
Mailing Address - Phone:419-455-6891
Mailing Address - Fax:
Practice Address - Street 1:200 SAINT FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3458
Practice Address - Country:US
Practice Address - Phone:419-455-6891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7295251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0132014Medicaid