Provider Demographics
NPI:1780835967
Name:FOLINO, RACHELLE VANESSA (MFT)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:VANESSA
Last Name:FOLINO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PARK RD
Mailing Address - Street 2:STE 220
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-4191
Mailing Address - Country:US
Mailing Address - Phone:865-366-1425
Mailing Address - Fax:865-366-1435
Practice Address - Street 1:400 PARK RD
Practice Address - Street 2:STE 220
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-4191
Practice Address - Country:US
Practice Address - Phone:865-366-1425
Practice Address - Fax:865-366-1435
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49204106H00000X
TN1038106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013546Medicaid