Provider Demographics
NPI:1790838738
Name:RABINOWITZ, REA E (MSW)
Entity Type:Individual
Prefix:
First Name:REA
Middle Name:E
Last Name:RABINOWITZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-2619
Mailing Address - Country:US
Mailing Address - Phone:508-764-2736
Mailing Address - Fax:508-764-4243
Practice Address - Street 1:63 EVERETT ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-2619
Practice Address - Country:US
Practice Address - Phone:508-764-2736
Practice Address - Fax:508-764-4243
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1041951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA714828OtherTUFTS HEALTH PLAN
MARAP02236OtherBCBS OF MA
MA15124OtherCIGNA BEHAVIORAL HEALTH
MA023080000OtherMAGELLAN BEHAVIORALHEALTH
MARAP02236OtherBCBS OF MA