Provider Demographics
NPI:1427768258
Name:SCARBERRY, RACHEL DAWN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:DAWN
Last Name:SCARBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:DAWN
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4757 ROUTE 152 STE 2
Mailing Address - Street 2:
Mailing Address - City:LAVALETTE
Mailing Address - State:WV
Mailing Address - Zip Code:25535-9638
Mailing Address - Country:US
Mailing Address - Phone:304-522-1945
Mailing Address - Fax:304-522-1946
Practice Address - Street 1:4757 ROUTE 152 STE 2
Practice Address - Street 2:
Practice Address - City:LAVALETTE
Practice Address - State:WV
Practice Address - Zip Code:25535-9638
Practice Address - Country:US
Practice Address - Phone:304-522-1945
Practice Address - Fax:304-522-1946
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator