Provider Demographics
NPI:1710579768
Name:POOLE, RACHEAL ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEAL
Middle Name:ELIZABETH
Last Name:POOLE
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 1:268 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1420
Mailing Address - Country:US
Mailing Address - Phone:716-244-2912
Mailing Address - Fax:
Practice Address - Street 1:268 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1420
Practice Address - Country:US
Practice Address - Phone:716-244-2912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084172101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor