Provider Demographics
NPI:1700040862
Name:GOLDEN, RACHEL NICOLE (MSW, U/S)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:MSW, U/S
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:NICOLE
Other - Last Name:PROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CM II
Mailing Address - Street 1:24797 OK-66 #5
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74019
Mailing Address - Country:US
Mailing Address - Phone:918-342-2080
Mailing Address - Fax:
Practice Address - Street 1:24797 OK-66 #5
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019
Practice Address - Country:US
Practice Address - Phone:918-342-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OK65181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator