Healthcare Provider Details

I. General information

NPI: 1578939724
Provider Name (Legal Business Name): RACHEL BIEU PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 W JOHNSON AVE STE 104
CHESHIRE CT
06410-4506
US

IV. Provider business mailing address

609 W JOHNSON AVE STE 104
CHESHIRE CT
06410-4506
US

V. Phone/Fax

Practice location:
  • Phone: 203-272-6007
  • Fax: 203-272-8895
Mailing address:
  • Phone: 203-272-6007
  • Fax: 203-272-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5158
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: