Provider Demographics
NPI:1861928210
Name:RURYCZ, RACHELLE (MSW)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:RURYCZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PRINCESS PINE RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-2438
Mailing Address - Country:US
Mailing Address - Phone:508-728-7965
Mailing Address - Fax:
Practice Address - Street 1:134 ANSEL HALLET RD
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673-2582
Practice Address - Country:US
Practice Address - Phone:774-470-2298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1246161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical