Provider Demographics
NPI:1588193064
Name:SPRUILL, RACHEL ELIZABETH (LSW,MED)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:LSW,MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 CHIMNEY ROCK RD APT 351
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2021
Mailing Address - Country:US
Mailing Address - Phone:313-377-0247
Mailing Address - Fax:
Practice Address - Street 1:5401 CHIMNEY ROCK RD APT 351
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2021
Practice Address - Country:US
Practice Address - Phone:313-377-0247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PA1041C0700X
TX1060881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)