Provider Demographics
NPI:1538725163
Name:CAIN, RACHEL LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LYNN
Last Name:CAIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6851 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-9494
Mailing Address - Country:US
Mailing Address - Phone:850-758-7155
Mailing Address - Fax:
Practice Address - Street 1:JACC HUDVASH C/O RACHEL CAIN
Practice Address - Street 2:790 VETERAN'S WAY
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507
Practice Address - Country:US
Practice Address - Phone:850-912-2506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW144091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW14409OtherVA HEALTHCARE FOR HOMELESS VETERANS