Provider Demographics
NPI:1891972691
Name:REHMER, CHARLES E (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:E
Last Name:REHMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HAYNES ST
Mailing Address - Street 2:MMH-ED CRISIS OFFICE
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4131
Mailing Address - Country:US
Mailing Address - Phone:860-647-6800
Mailing Address - Fax:860-647-6831
Practice Address - Street 1:71 HAYNES ST
Practice Address - Street 2:MMH-ED CRISIS OFFICE
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4131
Practice Address - Country:US
Practice Address - Phone:860-647-6800
Practice Address - Fax:860-647-6831
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0043271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004327OtherLCSW LICENSE NUMBER