Provider Demographics
NPI:1235598046
Name:MIKOLASY, RACHEL EMMA MARGARET (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:EMMA MARGARET
Last Name:MIKOLASY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:EMMA MARGARET
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMFT
Mailing Address - Street 1:PO BOX 4231
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-0231
Mailing Address - Country:US
Mailing Address - Phone:619-693-7576
Mailing Address - Fax:
Practice Address - Street 1:9 S WASHINGTON ST STE 420
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3709
Practice Address - Country:US
Practice Address - Phone:619-693-7576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60812427106H00000X
CAIMFT89528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA136Medicaid
1497237457OtherOTHER NPI NUMBER