Provider Demographics
NPI:1629339528
Name:GREN, RACHEL MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MARIE
Last Name:GREN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:BINNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFTI
Mailing Address - Street 1:PO BOX 1421
Mailing Address - Street 2:
Mailing Address - City:NORTH FORK
Mailing Address - State:CA
Mailing Address - Zip Code:93643-1421
Mailing Address - Country:US
Mailing Address - Phone:559-586-0881
Mailing Address - Fax:
Practice Address - Street 1:35686 HIGHWAY 41 STE C
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614-8744
Practice Address - Country:US
Practice Address - Phone:559-586-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 106H00000X
CA110765106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)