Provider Demographics
NPI:1508104175
Name:TAYLOR, RACHEL (MS, LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SW MADISON AVE
Mailing Address - Street 2:SUITE J-2
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4799
Mailing Address - Country:US
Mailing Address - Phone:541-286-5330
Mailing Address - Fax:541-636-2453
Practice Address - Street 1:425 SW MADISON AVE
Practice Address - Street 2:SUITE J-2
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4799
Practice Address - Country:US
Practice Address - Phone:541-286-5330
Practice Address - Fax:541-636-2453
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3483101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor