Provider Demographics
NPI:1235436775
Name:YOUNG, RACHEL ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:YOUNG
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 1:2213 CLEVELAND HWY
Mailing Address - Street 2:PO BOX 1662
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-8152
Mailing Address - Country:US
Mailing Address - Phone:706-259-4961
Mailing Address - Fax:706-259-4102
Practice Address - Street 1:2213 CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8152
Practice Address - Country:US
Practice Address - Phone:706-259-4961
Practice Address - Fax:706-259-4102
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional