Provider Demographics
NPI:1992164453
Name:MCGINNIS, RACHEL KRISTEN (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KRISTEN
Last Name:MCGINNIS
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 1:3155 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2542
Mailing Address - Country:US
Mailing Address - Phone:678-712-6520
Mailing Address - Fax:678-712-6521
Practice Address - Street 1:3155 MILL STREET
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2542
Practice Address - Country:US
Practice Address - Phone:678-712-6520
Practice Address - Fax:678-712-6521
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0056891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical