Provider Demographics
NPI:1922251974
Name:HOPPER, RACHAEL AH (PHD, LADAC)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:AH
Last Name:HOPPER
Suffix:
Gender:F
Credentials:PHD, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 MORROW ST N STE D
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-4324
Mailing Address - Country:US
Mailing Address - Phone:479-222-0981
Mailing Address - Fax:
Practice Address - Street 1:1201 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2513
Practice Address - Country:US
Practice Address - Phone:479-222-0981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR371L101YA0400X
AR10-01P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)