Provider Demographics
NPI:1326536236
Name:BLANFORD, RACHEL M (MSW, CSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:BLANFORD
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N CHARITY HTS
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-8740
Mailing Address - Country:US
Mailing Address - Phone:502-316-2805
Mailing Address - Fax:
Practice Address - Street 1:115 S SALEM DR
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1762
Practice Address - Country:US
Practice Address - Phone:502-331-5478
Practice Address - Fax:502-385-0234
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2554041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty