Provider Demographics
NPI:1619775376
Name:MCCRUM, RACHEL CLINE (CSW09931586)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CLINE
Last Name:MCCRUM
Suffix:
Gender:F
Credentials:CSW09931586
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10526 BERTHOUD WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9139
Mailing Address - Country:US
Mailing Address - Phone:312-810-3436
Mailing Address - Fax:
Practice Address - Street 1:10526 BERTHOUD WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9139
Practice Address - Country:US
Practice Address - Phone:312-810-3436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1041C0700X
COCSW.099315861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical