Healthcare Provider Details

I. General information

NPI: 1598957896
Provider Name (Legal Business Name): RACHEL CS BUSCH MA, LMHC, ATR, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SALT POND RD STE B4
WAKEFIELD RI
02879-4320
US

IV. Provider business mailing address

24 SALT POND RD STE B4
WAKEFIELD RI
02879-4320
US

V. Phone/Fax

Practice location:
  • Phone: 401-783-1310
  • Fax:
Mailing address:
  • Phone: 401-783-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00250
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: