Provider Demographics
NPI:1730420308
Name:O'FARRELL, RACHEL MARIE (LCSW, MPH, CCLS)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MARIE
Last Name:O'FARRELL
Suffix:
Gender:F
Credentials:LCSW, MPH, CCLS
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE
Mailing Address - Street 2:KY CLINIC J420
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-257-2470
Mailing Address - Fax:859-323-5971
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:KY CLINIC J420
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-257-2470
Practice Address - Fax:859-323-5971
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical