Provider Demographics
NPI:1598492076
Name:LANHAM, RACHEL ANN MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN MARIE
Last Name:LANHAM
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 HATCHET DR
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-2733
Mailing Address - Country:US
Mailing Address - Phone:636-385-2116
Mailing Address - Fax:
Practice Address - Street 1:120 N CHERRY ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1802
Practice Address - Country:US
Practice Address - Phone:636-385-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2208.304104100000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker