Healthcare Provider Details

I. General information

NPI: 1134998008
Provider Name (Legal Business Name): RACHEL RIMM LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 ADAM CLAYTON POWELL JR BLVD
NEW YORK NY
10027-4990
US

IV. Provider business mailing address

2090 ADAM CLAYTON POWELL JR BLVD
NEW YORK NY
10027-4990
US

V. Phone/Fax

Practice location:
  • Phone: 212-553-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121556-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: