Provider Demographics
NPI:1417321290
Name:PRIDGEN, RACHEL (MSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PRIDGEN
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 1:205B CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-3701
Mailing Address - Country:US
Mailing Address - Phone:334-892-3252
Mailing Address - Fax:
Practice Address - Street 1:205B CHURCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-3701
Practice Address - Country:US
Practice Address - Phone:334-892-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical