Healthcare Provider Details

I. General information

NPI: 1255732384
Provider Name (Legal Business Name): RACHEL FAGAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL GARRETT LPC

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

777 BANNOCK ST
DENVER CO
80204-4597
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax:
Mailing address:
  • Phone: 303-436-4949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC.0014708
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0014896
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: