Provider Demographics
NPI:1063886273
Name:STRUNK, RACHEL RUSSO (LISW-S, LICDC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:RUSSO
Last Name:STRUNK
Suffix:
Gender:F
Credentials:LISW-S, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 PENDLETON ST
Mailing Address - Street 2:SUITE #440
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7411
Mailing Address - Country:US
Mailing Address - Phone:513-356-9446
Mailing Address - Fax:
Practice Address - Street 1:1118 PENDLETON ST
Practice Address - Street 2:SUITE #440
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7411
Practice Address - Country:US
Practice Address - Phone:513-356-9446
Practice Address - Fax:513-206-9681
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-25
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1801112-SUPV104100000X
OHS.1510116-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker