Provider Demographics
NPI:1871138792
Name:KHAN-MCCROY, RACHEL ANN (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:KHAN-MCCROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MARIN BLVD APT 511
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-6494
Mailing Address - Country:US
Mailing Address - Phone:347-930-8666
Mailing Address - Fax:
Practice Address - Street 1:201 MARIN BLVD APT 511
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-6494
Practice Address - Country:US
Practice Address - Phone:347-930-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0859131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical