Provider Demographics
NPI:1265253629
Name:LIM, RACHEL SUSANNE (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SUSANNE
Last Name:LIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4191 INNSLAKE DR STE 211
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3324
Mailing Address - Country:US
Mailing Address - Phone:804-303-9622
Mailing Address - Fax:804-401-8135
Practice Address - Street 1:1503 SANTA ROSA ROAD
Practice Address - Street 2:SUITE 211
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229
Practice Address - Country:US
Practice Address - Phone:804-419-3283
Practice Address - Fax:804-716-4318
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040175311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical