Provider Demographics
NPI:1942932629
Name:MOORE, RACHEL SUZANNE (LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUZANNE
Last Name:MOORE
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 1:3380 TREMONT RD STE 280
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2140
Mailing Address - Country:US
Mailing Address - Phone:614-869-4816
Mailing Address - Fax:
Practice Address - Street 1:3380 TREMONT RD STE 280
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2140
Practice Address - Country:US
Practice Address - Phone:614-869-4816
Practice Address - Fax:614-372-5590
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional