Provider Demographics
NPI:1013521889
Name:ROSS, RACHAEL ELIZABETH (MHC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:ROSS
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ELIZABETH
Other - Last Name:CRUPPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1297
Mailing Address - Country:US
Mailing Address - Phone:855-922-2500
Mailing Address - Fax:
Practice Address - Street 1:490 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1297
Practice Address - Country:US
Practice Address - Phone:585-922-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health