Provider Demographics
NPI:1932451820
Name:SMITH, RACHELL KILLILEA (LSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHELL
Middle Name:KILLILEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 COOPER RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8984
Mailing Address - Country:US
Mailing Address - Phone:614-259-5409
Mailing Address - Fax:
Practice Address - Street 1:6000 COOPER RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8984
Practice Address - Country:US
Practice Address - Phone:614-259-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100807104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker