Provider Demographics
NPI:1013613579
Name:VASS, RACHELE M (CDCA)
Entity Type:Individual
Prefix:
First Name:RACHELE
Middle Name:M
Last Name:VASS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 ELM ST
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1117
Mailing Address - Country:US
Mailing Address - Phone:330-540-9544
Mailing Address - Fax:
Practice Address - Street 1:6 W FEDERAL ST STE 701
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44503-1440
Practice Address - Country:US
Practice Address - Phone:330-797-3995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.183388101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)