Provider Demographics
NPI:1891930525
Name:MEADOWS, RACHAEL LYN (LPC)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LYN
Last Name:MEADOWS
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 1:1154 OURAY AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3334
Mailing Address - Country:US
Mailing Address - Phone:970-314-4919
Mailing Address - Fax:
Practice Address - Street 1:1003 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3540
Practice Address - Country:US
Practice Address - Phone:970-314-4919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional