Provider Demographics
NPI:1043817059
Name:COSTER, RACHEL (LICSW, LADC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:COSTER
Suffix:
Gender:F
Credentials:LICSW, LADC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:208 FLYNN AVE STE 3J
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5420
Mailing Address - Country:US
Mailing Address - Phone:802-488-6920
Mailing Address - Fax:802-488-6919
Practice Address - Street 1:855 PINE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4924
Practice Address - Country:US
Practice Address - Phone:802-488-6000
Practice Address - Fax:802-488-6919
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-01343241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical