Provider Demographics
NPI:1619406600
Name:LARRETA, RACHEL KIMBERLY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:KIMBERLY
Last Name:LARRETA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S CAPITAL OF TEXAS HWY STE A280
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6478
Mailing Address - Country:US
Mailing Address - Phone:512-937-2904
Mailing Address - Fax:
Practice Address - Street 1:1101 S CAPITAL OF TEXAS HWY STE A280
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6478
Practice Address - Country:US
Practice Address - Phone:512-937-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist