Provider Demographics
NPI:1376933440
Name:HENRY, RACHEL F (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:F
Last Name:HENRY
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:MISS
Other - First Name:RACHEL
Other - Middle Name:F
Other - Last Name:WILT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:260 SEVEN FARMS DR STE C
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8207
Mailing Address - Country:US
Mailing Address - Phone:843-885-8650
Mailing Address - Fax:877-780-1103
Practice Address - Street 1:260 SEVEN FARMS DR STE C
Practice Address - Street 2:
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492
Practice Address - Country:US
Practice Address - Phone:843-885-8650
Practice Address - Fax:877-780-1103
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3348Medicare PIN
SC435201Medicaid