Provider Demographics
NPI:1417051004
Name:RASCO, ELAINE G (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:G
Last Name:RASCO
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELAINE
Other - Last Name:GAMEL-RASCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-S
Mailing Address - Street 1:1733 LINTHICUM ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35217-3214
Mailing Address - Country:US
Mailing Address - Phone:205-253-6520
Mailing Address - Fax:205-259-1626
Practice Address - Street 1:4268 CAHABA HEIGHTS CT STE 129
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5741
Practice Address - Country:US
Practice Address - Phone:205-968-8360
Practice Address - Fax:205-259-1626
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
AL2177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALLPC2177OtherALA BD EXAMINERS IN COUNS
AL801OtherSUPERVISORY LEVEL COUNSELOR