Provider Demographics
NPI:1225210560
Name:GOREN, RACHEL (MA, LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GOREN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 COMPUTER RD
Mailing Address - Street 2:C13
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1752
Mailing Address - Country:US
Mailing Address - Phone:215-240-1976
Mailing Address - Fax:215-240-1976
Practice Address - Street 1:2300 COMPUTER RD
Practice Address - Street 2:C13
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1752
Practice Address - Country:US
Practice Address - Phone:215-240-1976
Practice Address - Fax:215-240-1976
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPC005101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)