Provider Demographics
NPI:1437878840
Name:RACHEL LATHROP LICSW LLC
Entity Type:Organization
Organization Name:RACHEL LATHROP LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LATHROP
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:205-454-5673
Mailing Address - Street 1:4126 RICHMOND ST
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-2175
Mailing Address - Country:US
Mailing Address - Phone:205-454-5673
Mailing Address - Fax:
Practice Address - Street 1:4126 RICHMOND ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-2175
Practice Address - Country:US
Practice Address - Phone:205-454-5673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty