Provider Demographics
NPI:1477285104
Name:MARTIN, RACHEL MERRITT (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MERRITT
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5288 HICKORY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-9339
Mailing Address - Country:US
Mailing Address - Phone:704-674-7673
Mailing Address - Fax:
Practice Address - Street 1:5970 FAIRVIEW RD STE 126
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2100
Practice Address - Country:US
Practice Address - Phone:704-762-1361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0178431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical