Provider Demographics
NPI:1871033670
Name:MATHEW, RAHAEL (LPC)
Entity Type:Individual
Prefix:
First Name:RAHAEL
Middle Name:
Last Name:MATHEW
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 1:3436 N KENNICOTT AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7814
Mailing Address - Country:US
Mailing Address - Phone:847-952-7460
Mailing Address - Fax:847-222-1754
Practice Address - Street 1:2101 S ARLINGTON HEIGHTS RD STE 116
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4142
Practice Address - Country:US
Practice Address - Phone:847-666-6533
Practice Address - Fax:847-637-5479
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178012336101YP2500X
IL180012083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional