Healthcare Provider Details

I. General information

NPI: 1699220574
Provider Name (Legal Business Name): RACHEL GILBERT PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL E WESTERHOFF PSYD

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 WETHERSFIELD AVE
HARTFORD CT
06114-1420
US

IV. Provider business mailing address

84 SKYLINE DR
SALEM CT
06420-4107
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-4511
  • Fax:
Mailing address:
  • Phone: 209-768-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003829
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: