Provider Demographics
NPI:1568656460
Name:LIVELY, RACHEL (LICPSY)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:LIVELY
Suffix:
Gender:F
Credentials:LICPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MARKET ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3941
Mailing Address - Country:US
Mailing Address - Phone:508-221-4844
Mailing Address - Fax:
Practice Address - Street 1:28 MARKET ST STE 4
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3941
Practice Address - Country:US
Practice Address - Phone:508-221-4844
Practice Address - Fax:508-379-6012
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8729103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical