Provider Demographics
NPI:1649478777
Name:UMEH, RACHEL E (MA, LPA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:UMEH
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:EVE
Other - Last Name:DOZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPA
Mailing Address - Street 1:218 D ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-3104
Mailing Address - Country:US
Mailing Address - Phone:304-720-3835
Mailing Address - Fax:304-720-3836
Practice Address - Street 1:12 KANAWHA TER
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-2750
Practice Address - Country:US
Practice Address - Phone:304-201-1130
Practice Address - Fax:304-201-1134
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV103K00000X
KY103T00000X
WVGOLD CARD103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30610026Medicaid
000000536735OtherANTHEM BCBS