Provider Demographics
NPI:1265907042
Name:ALVARENGA, RACHEL LORENA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LORENA
Last Name:ALVARENGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LORENA
Other - Last Name:PETEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-1318
Mailing Address - Country:US
Mailing Address - Phone:617-232-6120
Mailing Address - Fax:
Practice Address - Street 1:250 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-1318
Practice Address - Country:US
Practice Address - Phone:617-232-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1210831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical