Provider Demographics
NPI:1689018285
Name:ROTEM, RACHEL ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:ROTEM
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 1:8116 VIADANA BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-5025
Mailing Address - Country:US
Mailing Address - Phone:561-373-0077
Mailing Address - Fax:
Practice Address - Street 1:660 LINTON BLVD
Practice Address - Street 2:STE 206F
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-8202
Practice Address - Country:US
Practice Address - Phone:561-373-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW110981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical