Provider Demographics
NPI:1013683341
Name:FISHER-DENHAM, RAKINZIE MONIQUE (LCSW)
Entity type:Individual
Prefix:
First Name:RAKINZIE
Middle Name:MONIQUE
Last Name:FISHER-DENHAM
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:ALEXANDRIA VA HEALTH CARE SYSTEM
Mailing Address - Street 2:2495 SHREVEPORT HIGHWAY
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360
Mailing Address - Country:US
Mailing Address - Phone:313-186-2306
Mailing Address - Fax:
Practice Address - Street 1:ALEXANDRIA VA HEALTH CARE SYSTEM
Practice Address - Street 2:2495 SHREVEPORT HIGHWAY
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360
Practice Address - Country:US
Practice Address - Phone:318-623-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA82311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical