Provider Demographics
NPI:1013772946
Name:BECERRA, RACHEL (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BECERRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BECERRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1110 SE ALDER STREET, SUITE 301 #169
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:206-260-5873
Mailing Address - Fax:
Practice Address - Street 1:3434 S KELLY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4630
Practice Address - Country:US
Practice Address - Phone:503-908-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL68451041C0700X
WA604865561041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical