Provider Demographics
NPI:1427802826
Name:PATTERSON, RACHAEL MARIE (LIMHP, LCSW)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:MARIE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LIMHP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15369 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-1582
Mailing Address - Country:US
Mailing Address - Phone:801-694-8045
Mailing Address - Fax:
Practice Address - Street 1:14747 CALIFORNIA ST STE 1
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-1986
Practice Address - Country:US
Practice Address - Phone:402-330-0960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011049971041C0700X
UT8018587-35011041C0700X
IA1237801041C0700X
NE3604101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical