MEDICARE: MRS. RACHEL SMITH BURNS LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	A14256	NC
2	101YP2500X	Professional Counselor	14256	NC

General Provider Information

NPI Number	:	1629553540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHEL SMITH BURNS LCMHC

Provider Business Mailing Address
First Line	:	7406 CHAPEL HILL RD STE K1
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5077
Country	:	US
Telephone Number	:	984-464-1472
Fax Number	:

Provider Business Practice Location Address
First Line	:	7406 CHAPEL HILL RD STE K1
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5077
Country	:	US
Telephone Number	:	984-464-1472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	09/29/2022

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