Provider Demographics
NPI:1164058327
Name:SCHIPP, RACHAEL M (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:M
Last Name:SCHIPP
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:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:FERDINAND
Mailing Address - State:IN
Mailing Address - Zip Code:47532-0219
Mailing Address - Country:US
Mailing Address - Phone:812-604-0619
Mailing Address - Fax:
Practice Address - Street 1:2115 MAIN ST
Practice Address - Street 2:
Practice Address - City:FERDINAND
Practice Address - State:IN
Practice Address - Zip Code:47532-9552
Practice Address - Country:US
Practice Address - Phone:812-604-0619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008809A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical