Healthcare Provider Details

I. General information

NPI: 1649612383
Provider Name (Legal Business Name): RACHEL KOHN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1540 CITRUS MEDICAL CT
OCOEE FL
34761-4547
US

IV. Provider business mailing address

1540 CITRUS MEDICAL CT
OCOEE FL
34761-4547
US

V. Phone/Fax

Practice location:
  • Phone: 407-602-7168
  • Fax:
Mailing address:
  • Phone: 407-602-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 12379
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: