Provider Demographics
NPI:1619560687
Name:LOFTY, RACHEL H (LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:H
Last Name:LOFTY
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 1:1860 BARNETT SHOALS RD STE 103
Mailing Address - Street 2:PMB 486
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-6821
Mailing Address - Country:US
Mailing Address - Phone:706-666-3345
Mailing Address - Fax:
Practice Address - Street 1:985 GAINES SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3133
Practice Address - Country:US
Practice Address - Phone:706-666-3345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008543101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional