Provider Demographics
NPI:1922433085
Name:BRIGGS GUTIERREZ, RACHEL (LCPC-6300)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BRIGGS GUTIERREZ
Suffix:
Gender:F
Credentials:LCPC-6300
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2799 S KNAPP AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-7925
Mailing Address - Country:US
Mailing Address - Phone:208-297-8464
Mailing Address - Fax:
Practice Address - Street 1:1010 W HAYS ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5435
Practice Address - Country:US
Practice Address - Phone:208-297-8464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5267101YM0800X
IDLCPC-6300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health