Provider Demographics
NPI:1447442579
Name:MCCARLEY, RACHEL K (LISW, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:K
Last Name:MCCARLEY
Suffix:
Gender:F
Credentials:LISW, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 METRO PL S STE 160
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5394
Mailing Address - Country:US
Mailing Address - Phone:614-580-6917
Mailing Address - Fax:
Practice Address - Street 1:495 METRO PL S STE 160
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5394
Practice Address - Country:US
Practice Address - Phone:614-580-6917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OHAPRN.CNP.0029159363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0400227Medicaid