Healthcare Provider Details

I. General information

NPI: 1629339528
Provider Name (Legal Business Name): RACHEL MARIE GREN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL MARIE BINNING MFTI

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35686 HIGHWAY 41 STE C
COARSEGOLD CA
93614-8744
US

IV. Provider business mailing address

PO BOX 1421
NORTH FORK CA
93643-1421
US

V. Phone/Fax

Practice location:
  • Phone: 559-586-0881
  • Fax:
Mailing address:
  • Phone: 559-586-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number110765
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: