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General NPI Number Information
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NPI Number | 1811148067
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Entity Type | Individual
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Provider Name | RACHEL RANDOLPH LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 11/30/2017
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Provider Practice Location Address
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Address Line | 348 13TH ST SUITE 203
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City | BROOKLYN
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State | NY
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Zip | 11215-5004
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Country | US
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Telephone | 718-788-2461
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Fax |
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Provider Business Mailing Address
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Address Line | 148 WILSON AVE
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City | BROOKLYN
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State | NY
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Zip | 11237-8042
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Country | US
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Telephone | 347-474-8464
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Fax | 347-630-0519
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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 |
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License Number State |
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