Provider Demographics
NPI:1295009298
Name:RACHLIN, JULIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:RACHLIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 W FAIRVIEW AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5120
Mailing Address - Country:US
Mailing Address - Phone:208-515-6805
Mailing Address - Fax:
Practice Address - Street 1:1655 W FAIRVIEW AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5120
Practice Address - Country:US
Practice Address - Phone:208-515-6805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC- 5551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional