Healthcare Provider Details

I. General information

NPI: 1932663408
Provider Name (Legal Business Name): RACHAEL STAMM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 10/15/2020
Certification Date: 10/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 PERKIOMEN AVE
READING PA
19602-1337
US

IV. Provider business mailing address

3345 HARRISON AVE
READING PA
19605-1647
US

V. Phone/Fax

Practice location:
  • Phone: 610-396-9091
  • Fax:
Mailing address:
  • Phone: 484-274-8515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW021399
License Number StatePA

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: