Provider Demographics
NPI:1538701164
Name:BARAKS, RACHEL (LMHC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BARAKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:COAL VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61240-9302
Mailing Address - Country:US
Mailing Address - Phone:309-373-7142
Mailing Address - Fax:
Practice Address - Street 1:3350 UTICA RIDGE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1616
Practice Address - Country:US
Practice Address - Phone:563-293-6859
Practice Address - Fax:563-594-5209
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.015062101YP2500X
101YP2500X
IA108766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional