Provider Demographics
NPI:1982957502
Name:DADBIN, RACHAEL SHANBROM (MA, LMFT # 138618)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:SHANBROM
Last Name:DADBIN
Suffix:
Gender:F
Credentials:MA, LMFT # 138618
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:FARRYN
Other - Last Name:SHANBROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SA COUNSELOR
Mailing Address - Street 1:5872 WHEELHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5872 WHEELHOUSE LN
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-1436
Practice Address - Country:US
Practice Address - Phone:818-900-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA138618106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)