Provider Demographics
NPI:1841627932
Name:PRACHT, REBECCA CLAIRE JOINER (LICSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLAIRE JOINER
Last Name:PRACHT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 ADELAIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-3210
Mailing Address - Country:US
Mailing Address - Phone:774-254-4429
Mailing Address - Fax:
Practice Address - Street 1:388 ADELAIDE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-3210
Practice Address - Country:US
Practice Address - Phone:774-254-4429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW026001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical