Provider Demographics
NPI:1659904423
Name:YEPEZ, RACHAEL A (LMSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:A
Last Name:YEPEZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 S 16TH PL
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128-9276
Mailing Address - Country:US
Mailing Address - Phone:520-510-1677
Mailing Address - Fax:
Practice Address - Street 1:188 S 16TH PL
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128-9276
Practice Address - Country:US
Practice Address - Phone:520-510-1677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker