Provider Demographics
NPI:1578697223
Name:BOEHMER, RACHAEL MADELINE (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MADELINE
Last Name:BOEHMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:LYN
Other - Last Name:UNSICKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:221 BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2542
Mailing Address - Country:US
Mailing Address - Phone:585-415-2677
Mailing Address - Fax:585-388-6004
Practice Address - Street 1:441 PENBROOKE DR STE 10
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2046
Practice Address - Country:US
Practice Address - Phone:585-388-6000
Practice Address - Fax:585-388-6004
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0737791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical