Basic Information
| Provider Information | |||||||||
| NPI: | 1982092938 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBB | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | ASENATH | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | ELMIRA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 149012849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077374927 | ||||||||
| FaxNumber: | 6077379080 | ||||||||
| Practice Location | |||||||||
| Address1: | 313 3RD ST | ||||||||
| Address2: | |||||||||
| City: | ITHACA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148503458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6072166683 | ||||||||
| FaxNumber: | 6072720232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/29/2014 | ||||||||
| LastUpdateDate: | 11/27/2019 | ||||||||
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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 | 089033 | NY | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | 087221-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.