Provider Demographics
NPI:1003342627
Name:WATKO, RACHEL MARIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MARIA
Last Name:WATKO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:MARIA
Other - Last Name:WATKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:786 D STREET
Mailing Address - Street 2:
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99505
Mailing Address - Country:US
Mailing Address - Phone:907-384-0405
Mailing Address - Fax:
Practice Address - Street 1:786 D STREET
Practice Address - Street 2:
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99505
Practice Address - Country:US
Practice Address - Phone:907-384-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-194871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical