Healthcare Provider Details

I. General information

NPI: 1982376844
Provider Name (Legal Business Name): RACHEL KUJAT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 HIGH MEADOW DR
DRUMS PA
18222-1741
US

IV. Provider business mailing address

27 HIGH MEADOW DR
DRUMS PA
18222-1741
US

V. Phone/Fax

Practice location:
  • Phone: 570-956-3363
  • Fax:
Mailing address:
  • Phone: 570-956-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC014773
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW022152
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06144500
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: