Healthcare Provider Details

I. General information

NPI: 1851042634
Provider Name (Legal Business Name): RACHEL ANN SCHWAB REHORKA MA LMHC 792
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2022
Last Update Date: 01/13/2022
Certification Date: 12/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 COOLEYVILLE RD
SHUTESBURY MA
01072-9766
US

IV. Provider business mailing address

PO BOX 682
SHUTESBURY MA
01072-0682
US

V. Phone/Fax

Practice location:
  • Phone: 978-407-4806
  • Fax:
Mailing address:
  • Phone: 978-407-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number792
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: