Provider Demographics
NPI:1013605062
Name:BRUTUS, RACHEL (LGSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BRUTUS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 TAILGATE TER
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4796
Mailing Address - Country:US
Mailing Address - Phone:786-877-9271
Mailing Address - Fax:
Practice Address - Street 1:1214 I ST SE APT 12
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4103
Practice Address - Country:US
Practice Address - Phone:202-249-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50081506101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health