Provider Demographics
NPI:1942078514
Name:SANTOS, RACHAEL ELIZABETH (LMHCA)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELIZABETH
Last Name:SANTOS
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 BOLES DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-7020
Mailing Address - Country:US
Mailing Address - Phone:765-667-9136
Mailing Address - Fax:
Practice Address - Street 1:10 S 9TH ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2630
Practice Address - Country:US
Practice Address - Phone:317-643-2210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001635A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health