Provider Demographics
NPI:1437690880
Name:DAVIS, RACHEL (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 KENILWORTH AVE APT F
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5262
Mailing Address - Country:US
Mailing Address - Phone:614-530-5902
Mailing Address - Fax:
Practice Address - Street 1:1508 KENILWORTH AVE APT F
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5262
Practice Address - Country:US
Practice Address - Phone:614-530-5902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-18
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0105471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical