Provider Demographics
NPI:1760702807
Name:ABRAXAS COUNSELING & CONSULTING, INC
Entity Type:Organization
Organization Name:ABRAXAS COUNSELING & CONSULTING, INC
Other - Org Name:RACHEL BURGETT, ARNP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURGETT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, CS
Authorized Official - Phone:360-871-2800
Mailing Address - Street 1:PO BOX 1586
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-0140
Mailing Address - Country:US
Mailing Address - Phone:360-871-2800
Mailing Address - Fax:360-871-3401
Practice Address - Street 1:7926 SE PROMENADE LN
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-9751
Practice Address - Country:US
Practice Address - Phone:360-871-2800
Practice Address - Fax:360-871-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004799101YM0800X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty