Provider Demographics
NPI:1467776047
Name:SUDDARTH, RACHEL M (LPC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:M
Last Name:SUDDARTH
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 1:18 REGENT PARK BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3727
Mailing Address - Country:US
Mailing Address - Phone:828-505-1762
Mailing Address - Fax:828-505-1763
Practice Address - Street 1:18 REGENT PARK BLVD STE A
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-3727
Practice Address - Country:US
Practice Address - Phone:828-505-1762
Practice Address - Fax:828-505-1763
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7883101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health