Provider Demographics
NPI:1669791935
Name:KIRBY, RACHEL A (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:K
Other - Last Name:CIBELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:2711 E MADISON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4749
Mailing Address - Country:US
Mailing Address - Phone:206-351-8646
Mailing Address - Fax:
Practice Address - Street 1:2711 E MADISON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4749
Practice Address - Country:US
Practice Address - Phone:206-351-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW601179981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical