Provider Demographics
NPI:1942831409
Name:BRADLEY HOLLIDAY, RACHEL (LMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BRADLEY HOLLIDAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:HOLLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2639
Mailing Address - Country:US
Mailing Address - Phone:614-722-3155
Mailing Address - Fax:614-355-4497
Practice Address - Street 1:444 BUTTERFLY GARDENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-3427
Practice Address - Country:US
Practice Address - Phone:614-938-0167
Practice Address - Fax:614-938-0170
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.2100182106H00000X
OHM.1800070106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1473276Medicaid