Provider Demographics
NPI:1407457385
Name:TREMBLEY, RACHEL MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:TREMBLEY
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 1:10403 SCHOOL HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1728
Mailing Address - Country:US
Mailing Address - Phone:586-292-6125
Mailing Address - Fax:
Practice Address - Street 1:10403 SCHOOL HOUSE LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1728
Practice Address - Country:US
Practice Address - Phone:586-292-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80253101YP2500X, 101YM0800X
TX101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool