Healthcare Provider Details

I. General information

NPI: 1871856484
Provider Name (Legal Business Name): RACHEL K BALDWIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 HOPE STREET 2ND FLOOR, UNIT 6
PROVIDENCE RI
02906
US

IV. Provider business mailing address

355 HOPE STREET 2ND FLOOR, UNIT 6
PROVIDENCE RI
02906
US

V. Phone/Fax

Practice location:
  • Phone: 401-402-0234
  • Fax:
Mailing address:
  • Phone: 401-402-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPS01438
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS01438
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPS01438
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: