Provider Demographics
NPI:1841928413
Name:GOODWIN, RACHELLE (MA, LPC, LCDC-I)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MA, LPC, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N SARAH DEEL DR APT 833
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-2656
Mailing Address - Country:US
Mailing Address - Phone:210-232-1030
Mailing Address - Fax:
Practice Address - Street 1:2743 SMITH RANCH RD UNIT 101
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5205
Practice Address - Country:US
Practice Address - Phone:281-778-9529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health