Healthcare Provider Details

I. General information

NPI: 1164938122
Provider Name (Legal Business Name): RACHEL A GABRIEL-NELSON LSCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL G NELSON

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 N 2ND ST
ATCHISON KS
66002-1203
US

IV. Provider business mailing address

1412 N 2ND ST
ATCHISON KS
66002-1203
US

V. Phone/Fax

Practice location:
  • Phone: 913-367-4879
  • Fax: 913-367-0240
Mailing address:
  • Phone: 913-367-4879
  • Fax: 913-367-0240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2006013587
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: