Provider Demographics
NPI:1104178185
Name:LATHAM, RACHEL L (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:L
Last Name:LATHAM
Suffix:
Gender:F
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, CAC
Mailing Address - Street 1:2368 FLAT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-3424
Mailing Address - Country:US
Mailing Address - Phone:706-255-7054
Mailing Address - Fax:
Practice Address - Street 1:2368 FLAT ROCK RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-3424
Practice Address - Country:US
Practice Address - Phone:864-933-7224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1107276101YA0400X
SC5151101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)