Provider Demographics
NPI:1811382740
Name:RACHEL, JOSEPH LEROY JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LEROY
Last Name:RACHEL
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 CARISMATIC LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2922
Mailing Address - Country:US
Mailing Address - Phone:512-952-0205
Mailing Address - Fax:
Practice Address - Street 1:508 CARISMATIC LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2922
Practice Address - Country:US
Practice Address - Phone:512-952-0205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-28
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22492103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical