Basic Information
| Provider Information | |||||||||
| NPI: | 1063658433 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOOLSON | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | SARAH | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.C.S.W. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 435 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | ROXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021191833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174427400 | ||||||||
| FaxNumber: | 6175413797 | ||||||||
| Practice Location | |||||||||
| Address1: | 435 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | ROXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021191833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174427400 | ||||||||
| FaxNumber: | 6175413797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2009 | ||||||||
| LastUpdateDate: | 01/06/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 215028 | MA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.