Provider Demographics
NPI:1477104313
Name:HENDRY, RACHAEL ELIZABETHE (LCSW)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETHE
Last Name:HENDRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4108
Mailing Address - Country:US
Mailing Address - Phone:530-826-6240
Mailing Address - Fax:406-721-2833
Practice Address - Street 1:336 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4108
Practice Address - Country:US
Practice Address - Phone:530-826-6240
Practice Address - Fax:406-721-2833
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABBS-LCSW-1306511041C0700X
171M00000X
MTBBH-LCSW-LIC-787281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator