Provider Demographics
NPI:1881853430
Name:BROEREN, RACHEL MARIE (LCPC CADC)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:MARIE
Last Name:BROEREN
Suffix:
Gender:F
Credentials:LCPC CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5217
Mailing Address - Country:US
Mailing Address - Phone:847-347-8663
Mailing Address - Fax:
Practice Address - Street 1:1200 SHERMER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4500
Practice Address - Country:US
Practice Address - Phone:847-347-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-07
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health