Healthcare Provider Details

I. General information

NPI: 1609493006
Provider Name (Legal Business Name): RACHEL GOTTLIEB-NORTON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL GOTTLIEB PSYD

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 GOLD STAR BLVD
WORCESTER MA
01606-2738
US

IV. Provider business mailing address

135 GOLD STAR BLVD
WORCESTER MA
01606-2738
US

V. Phone/Fax

Practice location:
  • Phone: 508-459-6407
  • Fax: 508-849-5618
Mailing address:
  • Phone: 508-459-6407
  • Fax: 508-849-5618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: