Provider Demographics
NPI:1558863829
Name:PEZZUTO, RACHEL (RC COUNSELOR)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PEZZUTO
Suffix:
Gender:F
Credentials:RC COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-6514
Mailing Address - Country:US
Mailing Address - Phone:781-296-0467
Mailing Address - Fax:844-511-5736
Practice Address - Street 1:13 LAKESHORE RD
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-6514
Practice Address - Country:US
Practice Address - Phone:781-296-0467
Practice Address - Fax:855-260-8265
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23043101YA0400X
MARC0402101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)