Provider Demographics
NPI:1639425671
Name:PERREAULT, RACHEL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:PERREAULT
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 1:1 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3905
Mailing Address - Country:US
Mailing Address - Phone:732-996-8280
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3905
Practice Address - Country:US
Practice Address - Phone:732-996-8280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055277001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical