Provider Demographics
NPI:1982944781
Name:ECCLES, RACHEL LYNN (MA LPCC-S)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LYNN
Last Name:ECCLES
Suffix:
Gender:F
Credentials:MA LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DELMAR PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41014-1457
Mailing Address - Country:US
Mailing Address - Phone:513-276-6901
Mailing Address - Fax:
Practice Address - Street 1:3325 GLENMORE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211
Practice Address - Country:US
Practice Address - Phone:513-231-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1100640101YM0800X
OHC.1100640101YP2500X
OHE.1100640.SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional