Healthcare Provider Details

I. General information

NPI: 1457295628
Provider Name (Legal Business Name): RACHEL SCULLY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MAIN ST
WETHERSFIELD CT
06109-3122
US

IV. Provider business mailing address

39 MAIN ST
WETHERSFIELD CT
06109-3122
US

V. Phone/Fax

Practice location:
  • Phone: 860-682-3603
  • Fax:
Mailing address:
  • Phone: 860-682-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RACHEL NATALIE SCULLY
Title or Position: OWNER, THERAPIST
Credential: LPC
Phone: 860-682-3603