Provider Demographics
NPI:1326167909
Name:JEBAILY, RACHAEL ELIZABETH (MSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:JEBAILY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 CHARLESTON RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2371
Mailing Address - Country:US
Mailing Address - Phone:919-606-6939
Mailing Address - Fax:
Practice Address - Street 1:1000 CORPORATE DR
Practice Address - Street 2:SUITE 401
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8535
Practice Address - Country:US
Practice Address - Phone:919-643-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1306875695Medicaid