Provider Demographics
NPI:1114473733
Name:ELDER, RACHEL (LMHC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 SW 106TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-1269
Mailing Address - Country:US
Mailing Address - Phone:317-902-6359
Mailing Address - Fax:
Practice Address - Street 1:2855 SW 106TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-1269
Practice Address - Country:US
Practice Address - Phone:317-902-6359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2020-06-24
Deactivation Date:2019-08-21
Deactivation Code:
Reactivation Date:2020-05-28
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60928751101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health