Provider Demographics
NPI:1548770167
Name:MANES, RACHEL LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:MANES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2413
Mailing Address - Country:US
Mailing Address - Phone:917-602-6201
Mailing Address - Fax:
Practice Address - Street 1:26 COURT ST STE 1416
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1114
Practice Address - Country:US
Practice Address - Phone:917-602-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0901921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical