Provider Demographics
NPI:1285257253
Name:DAVIS, RACHEL RHIANNON (LICSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RHIANNON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 POWDER MILL CT
Mailing Address - Street 2:
Mailing Address - City:INWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:25428-4619
Mailing Address - Country:US
Mailing Address - Phone:540-514-4814
Mailing Address - Fax:
Practice Address - Street 1:119 SADER DR STE 4
Practice Address - Street 2:
Practice Address - City:INWOOD
Practice Address - State:WV
Practice Address - Zip Code:25428-3915
Practice Address - Country:US
Practice Address - Phone:240-406-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-25
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP009447641041C0700X
WVDP009447641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical