Healthcare Provider Details

I. General information

NPI: 1275151185
Provider Name (Legal Business Name): RACHEL ELIZABETH ULRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LIMIT ST
LEAVENWORTH KS
66048-4435
US

IV. Provider business mailing address

500 LIMIT ST
LEAVENWORTH KS
66048-4435
US

V. Phone/Fax

Practice location:
  • Phone: 913-682-5118
  • Fax: 913-682-4664
Mailing address:
  • Phone: 913-682-5118
  • Fax: 913-682-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11681
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number202002065
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06485
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: