Healthcare Provider Details

I. General information

NPI: 1396360863
Provider Name (Legal Business Name): RACHEL ROSE MCCALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD
CINCINNATI OH
45206
US

IV. Provider business mailing address

1501 MADISON RD
CINCINNATI OH
45206
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-5200
  • Fax: 513-354-7115
Mailing address:
  • Phone: 513-354-5200
  • Fax: 513-354-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.193196
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: