Provider Demographics
NPI:1538481874
Name:CROLEY, RACHAEL DAWN (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:DAWN
Last Name:CROLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 HOLSBERRY RD STE B6
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-1320
Mailing Address - Country:US
Mailing Address - Phone:850-572-0635
Mailing Address - Fax:
Practice Address - Street 1:9511 HOLSBERRY RD STE B6
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-1320
Practice Address - Country:US
Practice Address - Phone:850-572-0635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 61561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical