Provider Demographics
NPI:1750656757
Name:ROSENFIELD, RACHEL J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:J
Last Name:ROSENFIELD
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 1:87 MONUMENT ST
Mailing Address - Street 2:#2
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4325
Mailing Address - Country:US
Mailing Address - Phone:518-330-6959
Mailing Address - Fax:
Practice Address - Street 1:87 MONUMENT ST
Practice Address - Street 2:#2
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4325
Practice Address - Country:US
Practice Address - Phone:518-330-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2015-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC130401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME104100000XOtherANTHEM BLUE CROSS