Healthcare Provider Details

I. General information

NPI: 1285557991
Provider Name (Legal Business Name): RACHEL FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 TWELVE OAKS WAY STE 101
WESLEY CHAPEL FL
33544-6970
US

IV. Provider business mailing address

18407 CANARY LN
LUTZ FL
33558-2715
US

V. Phone/Fax

Practice location:
  • Phone: 813-838-4807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH29337
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: