Provider Demographics
NPI:1134298383
Name:RACHAEL, SEJA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SEJA
Middle Name:
Last Name:RACHAEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 S 1ST ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-3061
Mailing Address - Country:US
Mailing Address - Phone:512-441-8334
Mailing Address - Fax:512-851-2226
Practice Address - Street 1:1310 S 1ST ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-3061
Practice Address - Country:US
Practice Address - Phone:512-441-8334
Practice Address - Fax:512-851-2226
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11543OtherLPC IDENTIFICATION