Healthcare Provider Details

I. General information

NPI: 1629790233
Provider Name (Legal Business Name): RACHEL BRENNAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LAFAYETTE BLVD STE 1100
BRIDGEPORT CT
06604-4710
US

IV. Provider business mailing address

20 MARTIN TER
HAMDEN CT
06517-2333
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 203-980-9294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number014720
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: