Provider Demographics
NPI:1073279725
Name:WAGSTER, RACHEL (LPCC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WAGSTER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10270 COMMONWEALTH ST APT 3265
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5611
Mailing Address - Country:US
Mailing Address - Phone:224-565-6792
Mailing Address - Fax:
Practice Address - Street 1:10270 COMMONWEALTH ST APT 3265
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5611
Practice Address - Country:US
Practice Address - Phone:224-565-6792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health