Provider Demographics
NPI:1609407915
Name:CAVALLARO, RACHEL MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARIE
Last Name:CAVALLARO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SEYMOUR ST STE 320
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3300
Mailing Address - Country:US
Mailing Address - Phone:860-972-4219
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR ST STE 320
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3300
Practice Address - Country:US
Practice Address - Phone:860-972-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005174103T00000X
MA319684103TA0400X
CT4257103TH0004X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth