Provider Demographics
NPI:1013346469
Name:TRIMBUR, RACHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:TRIMBUR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 GRAY RD STE F
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3238
Mailing Address - Country:US
Mailing Address - Phone:317-500-4178
Mailing Address - Fax:
Practice Address - Street 1:6801 GRAY RD STE F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-3238
Practice Address - Country:US
Practice Address - Phone:317-500-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007396A1041C0700X
IN87001614A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical