Healthcare Provider Details

I. General information

NPI: 1053908038
Provider Name (Legal Business Name): RACHEL ZOE BAUMANN LPC,M.A.,S.Y.C.,NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2020
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 WESTPORT AVE
NORWALK CT
06851-4440
US

IV. Provider business mailing address

82 FRONT ST APT A
GROTON CT
06340-5786
US

V. Phone/Fax

Practice location:
  • Phone: 203-533-1252
  • Fax:
Mailing address:
  • Phone: 203-533-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number46.005359
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberC082020000582
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: