Healthcare Provider Details

I. General information

NPI: 1639681596
Provider Name (Legal Business Name): RACHEL LEE KUDLER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5318 HIGHGATE DR STE 231
DURHAM NC
27713-6631
US

IV. Provider business mailing address

73 RUSSELL CHAPEL CHURCH RD
PITTSBORO NC
27312-7545
US

V. Phone/Fax

Practice location:
  • Phone: 919-416-0800
  • Fax: 919-416-0804
Mailing address:
  • Phone: 919-656-0352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006307
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: