Provider Demographics
NPI:1477969517
Name:BURGREEN, RACHEL (LCSW-S)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BURGREEN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 DEEN AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-5401
Mailing Address - Country:US
Mailing Address - Phone:512-703-0650
Mailing Address - Fax:
Practice Address - Street 1:105 DEEN AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-5401
Practice Address - Country:US
Practice Address - Phone:512-703-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX56555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker