Provider Demographics
NPI:1851713796
Name:HALLECK, RACHEL (LMHC, LAC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HALLECK
Suffix:
Gender:F
Credentials:LMHC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 N PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1020
Mailing Address - Country:US
Mailing Address - Phone:317-752-9042
Mailing Address - Fax:
Practice Address - Street 1:927 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1020
Practice Address - Country:US
Practice Address - Phone:317-752-9042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86000323A101YA0400X
IN39002402A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)