Provider Demographics
NPI:1124465935
Name:ZACCAGNINO, RACHEL ELISABETH (LCSWA, QP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELISABETH
Last Name:ZACCAGNINO
Suffix:
Gender:F
Credentials:LCSWA, QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 FORT BENNING RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31903-2834
Mailing Address - Country:US
Mailing Address - Phone:706-322-9599
Mailing Address - Fax:
Practice Address - Street 1:1600 FORT BENNING RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-2834
Practice Address - Country:US
Practice Address - Phone:706-322-9599
Practice Address - Fax:706-322-9567
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker