Provider Demographics
NPI:1174993729
Name:SPENCER, RACHEL KLARA MINK (OTR/L)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:KLARA MINK
Last Name:SPENCER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:KLARA
Other - Last Name:MINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2880 TRICOM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9171
Mailing Address - Country:US
Mailing Address - Phone:843-797-5050
Mailing Address - Fax:843-797-3633
Practice Address - Street 1:202 NEXTON SQUARE DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7911
Practice Address - Country:US
Practice Address - Phone:854-429-4263
Practice Address - Fax:843-767-8569
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4594225X00000X, 225XH1200X
VA0119009759225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH3009Medicaid
SCD043OtherARCIS HEALTHCARE GROUP MEDICARE PTAN
SCGP6337OtherARCIS HEALTHCARE GROUP MEDICAID NO.
SC7000950005OtherARCIS HEALTHCARE, LLC GROUP MEDICARE DME PTAN
SC7000950004OtherARCIS HEALTHCARE, LLC GROUP MEDICARE DME PTAN
SCP01555383OtherRAILROAD MEDICARE
SCD043OtherARCIS HEALTHCARE GROUP MEDICARE PTAN
SC7000950004OtherARCIS HEALTHCARE, LLC GROUP MEDICARE DME PTAN
SCD043OtherARCIS HEALTHCARE GROUP MEDICARE PTAN
SCP01555383OtherRAILROAD MEDICARE
SC46-2535418OtherARCIS HEALTHCARE GROUP TIN
SCTH3009Medicaid
SCP01555383OtherRAILROAD MEDICARE