Healthcare Provider Details

I. General information

NPI: 1316727852
Provider Name (Legal Business Name): RACHEL EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1531 ELMHURST DR
LONGMONT CO
80503-2322
US

IV. Provider business mailing address

6635 S DAYTON ST STE 310 PMB 112
GREENWOOD VILLAGE CO
80111
US

V. Phone/Fax

Practice location:
  • Phone: 917-319-5325
  • Fax:
Mailing address:
  • Phone: 720-828-2434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0022260
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0022260
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: