Provider Demographics
NPI:1356776090
Name:OMAHONEY, RACHEL GRIFFIN (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GRIFFIN
Last Name:OMAHONEY
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LYNN
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCDC, LPC
Mailing Address - Street 1:11506 POLLYANNA AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-2735
Mailing Address - Country:US
Mailing Address - Phone:512-964-6209
Mailing Address - Fax:
Practice Address - Street 1:2211 HANCOCK DR STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2508
Practice Address - Country:US
Practice Address - Phone:512-964-6209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11672101YA0400X
TX68924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)