Healthcare Provider Details

I. General information

NPI: 1154106078
Provider Name (Legal Business Name): RACHEL PELISSIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 BUD FORD TRL
CABOT AR
72023-7120
US

IV. Provider business mailing address

305 BUD FORD TRL
CABOT AR
72023-7120
US

V. Phone/Fax

Practice location:
  • Phone: 973-519-4583
  • Fax:
Mailing address:
  • Phone: 973-519-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16551
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06668200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13097-C
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111219
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11976-C
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6081501
License Number StateID
# 7
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2026-0265
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: