Provider Demographics
NPI:1659733764
Name:CHAPPELL, RACHAEL (LMSW, EDS)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:LMSW, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13403 N GOVERNMENT WAY UNIT 314
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-8903
Mailing Address - Country:US
Mailing Address - Phone:208-404-4391
Mailing Address - Fax:
Practice Address - Street 1:13403 N GOVERNMENT WAY UNIT 314
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8903
Practice Address - Country:US
Practice Address - Phone:208-404-4391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-33553104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker