Provider Demographics
NPI:1134535990
Name:PACKEE, RACHEL MARIE (LPC-SASD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:PACKEE
Suffix:
Gender:F
Credentials:LPC-SASD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:PACKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-SASD
Mailing Address - Street 1:714 E CUDAHY AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-5206
Mailing Address - Country:US
Mailing Address - Phone:414-559-1276
Mailing Address - Fax:
Practice Address - Street 1:10012 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1338
Practice Address - Country:US
Practice Address - Phone:414-810-4844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17160-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)