Provider Demographics
NPI:1770037608
Name:WIGGINS, RACHEL (LICSW)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11737 FAIRFAX WOODS WAY APT 5108
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8356
Mailing Address - Country:US
Mailing Address - Phone:540-425-2668
Mailing Address - Fax:
Practice Address - Street 1:4300 C ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4100
Practice Address - Country:US
Practice Address - Phone:202-248-7773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500808971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical