Individual provider Active NPI

Rachel L Warden, LCSW

  • Clinical Social Worker
  • Fayetteville, AR
National Provider Identifier
1962749895
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7680-C Issued in AR
Practice address
60 W Sunbridge Dr
Fayetteville, AR 72703
Phone
(479) 695-1240
Fax
(479) 750-4843
NPI assigned
Jan 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7680-C AR Primary

Addresses

Primary practice location

60 W Sunbridge Dr
Fayetteville, AR 72703

Mailing address

2400 S 48TH St
Springdale, AR 72762-6683
Phone (479) 750-2020

Other names 1

  • Rachel Ryan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7680-CARMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1962749895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-695-1240",
            "fax_number": "479-750-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "RACHEL",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7680-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "RYAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.