MEDICARE: RACHAEL LAUREN STERN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	72 081920	NY
2	1041C0700X	Clinical Social Worker	0903003714	VA
3	1041C0700X	Clinical Social Worker	LG200002347	DC
4	1041C0700X	Clinical Social Worker	16950	MD

General Provider Information

NPI Number	:	1255610002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL LAUREN STERN MSW

Provider Business Mailing Address
First Line	:	2121 EISENHOWER AVE STE 300
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4688
Country	:	US
Telephone Number	:	310-383-1090
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 EISENHOWER AVE STE 300
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4688
Country	:	US
Telephone Number	:	310-383-1090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2011
Last Update Date	:	04/01/2023

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