Provider Demographics
NPI:1912173485
Name:BLAKEMAN, RACHEL LISA (JD, LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LISA
Last Name:BLAKEMAN
Suffix:
Gender:F
Credentials:JD, LCSW-R
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:240 E 76TH ST
Mailing Address - Street 2:OFFICE: P-02
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2941
Mailing Address - Country:US
Mailing Address - Phone:212-472-2125
Mailing Address - Fax:212-772-0432
Practice Address - Street 1:240 E 76TH ST
Practice Address - Street 2:OFFICE: P-02
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2941
Practice Address - Country:US
Practice Address - Phone:212-472-2125
Practice Address - Fax:212-772-0432
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY061974 - R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical