Provider Demographics
NPI:1689390049
Name:THOMPSON, RACHAEL ALEXIS (LPC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ALEXIS
Last Name:THOMPSON
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 1:19551 TYRONNE AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2232
Mailing Address - Country:US
Mailing Address - Phone:216-372-6953
Mailing Address - Fax:
Practice Address - Street 1:19551 TYRONNE AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-2232
Practice Address - Country:US
Practice Address - Phone:216-372-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204653101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor