Provider Demographics
NPI:1700933538
Name:MCCARTHEY, RACHELE MARY (MD)
Entity Type:Individual
Prefix:
First Name:RACHELE
Middle Name:MARY
Last Name:MCCARTHEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:650 KOMAS DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1215
Mailing Address - Country:US
Mailing Address - Phone:801-585-1212
Mailing Address - Fax:801-585-9096
Practice Address - Street 1:650 KOMAS DR
Practice Address - Street 2:SUITE 208
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1215
Practice Address - Country:US
Practice Address - Phone:801-585-1212
Practice Address - Fax:801-585-9096
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6054301-1205208000000X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry