Provider Demographics
NPI:1013116680
Name:LENN, RACHEL F (PHD, CGP)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:F
Last Name:LENN
Suffix:
Gender:F
Credentials:PHD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9412 WOODINGTON DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-765-7615
Mailing Address - Fax:301-765-2972
Practice Address - Street 1:9412 WOODINGTON DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-2059
Practice Address - Country:US
Practice Address - Phone:301-765-7615
Practice Address - Fax:301-765-2972
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2596103T00000X, 103TA0700X, 103TC0700X, 103TP2701X, 106H00000X
MD2956103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI DO NOT KNOWMedicare PIN