Provider Demographics
NPI:1740894328
Name:MATZKIN, RACHEL ILANA (MSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ILANA
Last Name:MATZKIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ILANA
Other - Last Name:KLECHEVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:133 PRESIDENT ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4718
Mailing Address - Country:US
Mailing Address - Phone:718-909-8241
Mailing Address - Fax:
Practice Address - Street 1:133 PRESIDENT ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4718
Practice Address - Country:US
Practice Address - Phone:718-909-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0846431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical