Provider Demographics
NPI:1649045741
Name:CARLSON, RACHEL LUCILLE (LLMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LUCILLE
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9425
Mailing Address - Country:US
Mailing Address - Phone:517-336-6060
Mailing Address - Fax:517-252-2670
Practice Address - Street 1:3181 SANDHILL RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-9425
Practice Address - Country:US
Practice Address - Phone:517-336-6060
Practice Address - Fax:517-252-2670
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511156201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical