Healthcare Provider Details

I. General information

NPI: 1043125057
Provider Name (Legal Business Name): RACHEL GERENA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 BOND ST
BROOKLYN NY
11231-3767
US

IV. Provider business mailing address

PO BOX 150231
BROOKLYN NY
11215-0231
US

V. Phone/Fax

Practice location:
  • Phone: 929-456-3410
  • Fax:
Mailing address:
  • Phone: 929-456-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number002802-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: