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General NPI Number Information
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NPI Number | 1972972347
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Entity Type | Individual
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Provider Name | RACHEL MARIE PADALINO M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 03/30/2019
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Provider Practice Location Address
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Address Line | 921 N MAIN ST
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-1256
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Country | US
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Telephone | 270-806-0015
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Fax | 502-430-2416
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Provider Business Mailing Address
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Address Line | 1165 GANDY CT # A
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-3405
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Country | US
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Telephone | 269-806-2781
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 243043
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License Number State | KY
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