Provider Demographics
NPI:1699016089
Name:EPIFANIO, RACHEL (BA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:EPIFANIO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6339 CHARLOTTE PIKE PO BOX B144
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209
Mailing Address - Country:US
Mailing Address - Phone:216-767-7480
Mailing Address - Fax:
Practice Address - Street 1:522 CAMDEN DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-2002
Practice Address - Country:US
Practice Address - Phone:216-767-7480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103K00000XMedicaid