Provider Demographics
NPI:1952096307
Name:CARVAJAL, RACHEL A (MS ED, PD, NCSP)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:A
Last Name:CARVAJAL
Suffix:
Gender:F
Credentials:MS ED, PD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 BRONX RIVER RD APT 6E
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4037
Mailing Address - Country:US
Mailing Address - Phone:954-309-2786
Mailing Address - Fax:
Practice Address - Street 1:50 HAMILTON ST STE 4
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2863
Practice Address - Country:US
Practice Address - Phone:914-306-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NY1232653181103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103T00000XBehavioral Health & Social Service ProvidersPsychologist