Provider Demographics
NPI:1831488030
Name:RAWLINGS, TREVA RAE (LPC)
Entity Type:Individual
Prefix:
First Name:TREVA
Middle Name:RAE
Last Name:RAWLINGS
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:PO BOX 1235
Mailing Address - Street 2:7174 MAIN ST. SUITE A
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-8740
Mailing Address - Country:US
Mailing Address - Phone:208-946-1386
Mailing Address - Fax:208-267-0936
Practice Address - Street 1:7174 MAIN ST.
Practice Address - Street 2:SUITE A
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-8740
Practice Address - Country:US
Practice Address - Phone:208-267-0936
Practice Address - Fax:208-267-0936
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-4714101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLCPC-4714OtherSTATE LICENSE