Provider Demographics
NPI:1700327848
Name:DORSA, RACHEL EILEEN (LPC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:EILEEN
Last Name:DORSA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4460 BROOKFIELD CORPORATE DR STE H
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1671
Mailing Address - Country:US
Mailing Address - Phone:571-261-8239
Mailing Address - Fax:
Practice Address - Street 1:4460 BROOKFIELD CORPORATE DR STE H
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1671
Practice Address - Country:US
Practice Address - Phone:571-261-8239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701012012101YP2500X
LA6444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
13983189OtherCAQH
VA0701012012OtherVIRGINIA BOARD OF COUNSELING