1124240734 NPI number — DR. RACHEL LASCHEVER MOVITZ, PSY.D.

Table of content: (NPI 1124240734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124240734 NPI number — DR. RACHEL LASCHEVER MOVITZ, PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. RACHEL LASCHEVER MOVITZ, PSY.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124240734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 628
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01886
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-640-0900
Provider Business Mailing Address Fax Number:
978-486-9516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
198 GROTON ROAD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
AYER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-640-0900
Provider Business Practice Location Address Fax Number:
978-486-9516
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOVITZ
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
LASCHEVER
Authorized Official Title or Position:
LICENSED PSYCHOLOGIST
Authorized Official Telephone Number:
781-640-0900

Provider Taxonomy Codes

  • Taxonomy code: 103TA0700X , with the licence number:  8263 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1859731 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: W06374 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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