Provider Demographics
NPI:1780232751
Name:SELDIN, RACHAEL (LMSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:SELDIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 S 3RD ST APT 4528
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2195
Mailing Address - Country:US
Mailing Address - Phone:631-965-8673
Mailing Address - Fax:
Practice Address - Street 1:799 S 3RD ST APT 4528
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2195
Practice Address - Country:US
Practice Address - Phone:631-965-8673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103813104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker