Provider Demographics
NPI:1790438307
Name:TARLING, RACHEL JANE (LSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:JANE
Last Name:TARLING
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:JANE
Other - Last Name:TRABARIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:5547 N RAVENSWOOD AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1125
Mailing Address - Country:US
Mailing Address - Phone:773-609-2069
Mailing Address - Fax:
Practice Address - Street 1:5547 N RAVENSWOOD AVE STE 103
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1125
Practice Address - Country:US
Practice Address - Phone:773-609-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.105006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker