Provider Demographics
NPI:1245706191
Name:WEISSMAN, RACHEL (LMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WEISSMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 W 110TH ST APT 82
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2082
Mailing Address - Country:US
Mailing Address - Phone:845-594-3448
Mailing Address - Fax:
Practice Address - Street 1:57 W BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4038
Practice Address - Country:US
Practice Address - Phone:718-839-8900
Practice Address - Fax:718-299-4030
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104591-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical