Provider Demographics
NPI:1093138745
Name:MARX, RACHAEL GENE (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:GENE
Last Name:MARX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:GENE
Other - Last Name:BUMPOUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2197
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72503-2197
Mailing Address - Country:US
Mailing Address - Phone:870-698-2100
Mailing Address - Fax:
Practice Address - Street 1:70 BATESVILLE BLVD
Practice Address - Street 2:SUITE C.
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-8970
Practice Address - Country:US
Practice Address - Phone:870-799-4983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9055-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical