Provider Demographics
NPI:1669218426
Name:NEAHUSAN, RACHEL (MA, LPC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:NEAHUSAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4838 AMESBURY WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:MD
Mailing Address - Zip Code:21755-8127
Mailing Address - Country:US
Mailing Address - Phone:240-626-5874
Mailing Address - Fax:
Practice Address - Street 1:4838 AMESBURY WAY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:MD
Practice Address - Zip Code:21755-8127
Practice Address - Country:US
Practice Address - Phone:240-626-5874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health