Healthcare Provider Details

I. General information

NPI: 1508340670
Provider Name (Legal Business Name): RACHEL M BUCK LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2018
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DIRIGO HIGH SCHOOL 145 WELD ST
DIXFIELD ME
04224
US

IV. Provider business mailing address

RSU 56 145 WELD ST
DIXFIELD ME
04224
US

V. Phone/Fax

Practice location:
  • Phone: 207-562-4251
  • Fax: 207-364-1718
Mailing address:
  • Phone: 207-562-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC6620
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC18392
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberMC18392
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: