MEDICARE: VICKI JOSEPHINE RAHENKAMP LCPC

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	LC3358	MD
2	101YM0800X	Mental Health Counselor	LC3358	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	522156095	OTHER	MD	COMMERCIAL INS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780911784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI JOSEPHINE RAHENKAMP LCPC

Provider Business Mailing Address
First Line	:	808 S 5TH AVE
Second Line	:
City	:	DENTON
State	:	MD
Zip	:	21629-1398
Country	:	US
Telephone Number	:	410-479-2650
Fax Number	:	833-908-2283

Provider Business Practice Location Address
First Line	:	808 S 5TH AVE
Second Line	:
City	:	DENTON
State	:	MD
Zip	:	21629-1398
Country	:	US
Telephone Number	:	410-479-2650
Fax Number	:	833-908-2283

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

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	11/28/2023

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