Provider Demographics
NPI:1720231590
Name:TOLAN, RACHEL JANE (LICSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:TOLAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3321
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-0894
Mailing Address - Country:US
Mailing Address - Phone:781-733-1451
Mailing Address - Fax:978-998-4374
Practice Address - Street 1:900 CUMMINGS CTR
Practice Address - Street 2:SUITE 409-T
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6198
Practice Address - Country:US
Practice Address - Phone:781-733-1451
Practice Address - Fax:978-998-4374
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical