Provider Demographics
NPI:1306190582
Name:SAMS, RACHEL ERIN (LISW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ERIN
Last Name:SAMS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:RAQCHEL
Other - Middle Name:ERIN
Other - Last Name:MCMILLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:204 COOK RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9600
Mailing Address - Country:US
Mailing Address - Phone:513-228-7800
Mailing Address - Fax:513-695-2952
Practice Address - Street 1:953 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2921
Practice Address - Country:US
Practice Address - Phone:937-383-4441
Practice Address - Fax:937-383-2921
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-15024241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical