Provider Demographics
NPI:1801395280
Name:ADLER, RACHEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ADLER
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 1:200 4TH AVE S UNIT 407
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4395
Mailing Address - Country:US
Mailing Address - Phone:727-331-4048
Mailing Address - Fax:833-939-2011
Practice Address - Street 1:200 4TH AVE S UNIT 407
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4395
Practice Address - Country:US
Practice Address - Phone:727-331-4048
Practice Address - Fax:833-939-2011
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1229901041C0700X
FLSW159961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101846600Medicaid