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General NPI Number Information
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NPI Number | 1710493911
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Entity Type | Organization
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Legal Business Name | RACHEL DUBROW LCSW LLC
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 400 CENTRAL AVE STE 202
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City | NORTHFIELD
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State | IL
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Zip | 60093
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Country | US
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Telephone | 847-313-8074
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Fax | 847-423-6989
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Provider Business Mailing Address
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Address Line | 400 CENTRAL AVE STE 202
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City | NORTHFIELD
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State | IL
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Zip | 60093-3024
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Country | US
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Telephone | 847-313-8074
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Fax | 847-423-6989
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. RACHEL SMITH
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Credential | LCSW
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Telephone | 847-313-8074
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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 | 149015138
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License Number State | IL
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