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General NPI Number Information
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NPI Number | 1285753368
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Entity Type | Individual
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Provider Name | MICHAEL NEAL RABE LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 401 PENINSULA DR # 204
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City | LAKE ALMANOR
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State | CA
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Zip | 96137
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Country | US
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Telephone | 916-622-0057
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Fax |
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Provider Business Mailing Address
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Address Line | 401 PENINSULA DR # 204
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City | LAKE ALMANOR
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State | CA
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Zip | 96137-9658
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Country | US
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Telephone | 916-622-0057
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 21539
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License Number State | CA
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