Provider Demographics
NPI:1447594668
Name:GARRISON, RACHEL G (LCSW, LIP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:G
Last Name:GARRISON
Suffix:
Gender:F
Credentials:LCSW, LIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91068
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-1068
Mailing Address - Country:US
Mailing Address - Phone:251-602-0909
Mailing Address - Fax:
Practice Address - Street 1:705 OAK CIRCLE DR E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4221
Practice Address - Country:US
Practice Address - Phone:251-602-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0692-1549C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical