Provider Demographics
NPI:1003030958
Name:GREENSPAN, RACHEL LEIGH (LCPC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LEIGH
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 W ADAMS ST
Mailing Address - Street 2:#254
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2998
Mailing Address - Country:US
Mailing Address - Phone:312-666-4656
Mailing Address - Fax:312-666-4656
Practice Address - Street 1:1101 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-2903
Practice Address - Country:US
Practice Address - Phone:312-318-8105
Practice Address - Fax:312-666-4656
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional