Provider Demographics
NPI:1679890370
Name:HERNANDEZ, RACHAEL (MED, LPC, LADC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MED, LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1717
Mailing Address - Country:US
Mailing Address - Phone:405-939-5800
Mailing Address - Fax:
Practice Address - Street 1:6448 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1717
Practice Address - Country:US
Practice Address - Phone:405-939-5800
Practice Address - Fax:580-225-1130
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK734101YA0400X
OK3990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)