Provider Demographics
NPI:1265980197
Name:TONWAR, RACHELLE (NCC, LPC, PMH-C)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:TONWAR
Suffix:
Gender:F
Credentials:NCC, LPC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HOLLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9702
Mailing Address - Country:US
Mailing Address - Phone:678-845-8371
Mailing Address - Fax:678-807-2533
Practice Address - Street 1:102 MARY ALICE PARK RD STE 306
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2690
Practice Address - Country:US
Practice Address - Phone:678-845-8371
Practice Address - Fax:678-807-2533
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional