Provider Demographics
NPI:1093951501
Name:EDMUNDS, RACHEL HUGHES (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:HUGHES
Last Name:EDMUNDS
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 1:2217 PRINCESS ANNE ST
Mailing Address - Street 2:SUITE 105-5
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3353
Mailing Address - Country:US
Mailing Address - Phone:540-371-1006
Mailing Address - Fax:540-371-1911
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 105-5
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:540-371-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040069121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1093951501Medicaid
VAVAA103930 GROUPMedicare PIN
VA1093951501Medicaid