Provider Demographics
NPI:1700163078
Name:AYERS, RACHEL GREENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:GREENE
Last Name:AYERS
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 1:335 WASHNGTN ST SE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3616
Mailing Address - Country:US
Mailing Address - Phone:770-712-8432
Mailing Address - Fax:
Practice Address - Street 1:335 WASHNGTN ST SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3616
Practice Address - Country:US
Practice Address - Phone:770-712-8432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0045441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW004544OtherLCSW LICENSE NUMBER