Provider Demographics
NPI:1649877010
Name:GONZALES, RACHEL (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GONZALES
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4094 BOBWHITE
Mailing Address - Street 2:
Mailing Address - City:ROBSTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78380-6057
Mailing Address - Country:US
Mailing Address - Phone:512-461-8338
Mailing Address - Fax:
Practice Address - Street 1:4094 BOBWHITE
Practice Address - Street 2:
Practice Address - City:ROBSTOWN
Practice Address - State:TX
Practice Address - Zip Code:78380-6057
Practice Address - Country:US
Practice Address - Phone:512-461-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79598101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX79598OtherSTATE BOARD