Provider Demographics
NPI:1689131161
Name:COURTRIGHT, RACHELLE LYNN (LSW)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:LYNN
Last Name:COURTRIGHT
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:LYNN
Other - Last Name:DOBBINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:710 MAIN ST
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1615
Practice Address - Country:US
Practice Address - Phone:740-622-4470
Practice Address - Fax:740-622-5580
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2511790104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0336011Medicaid