Healthcare Provider Details

I. General information

NPI: 1013341205
Provider Name (Legal Business Name): RACHEL L TERRELL-BOODRAM LPC NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2013
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 HAMMOND DR UNIT 125
SANDY SPRINGS GA
30328-5593
US

IV. Provider business mailing address

799 HAMMOND DR UNIT 125
SANDY SPRINGS GA
30328-5593
US

V. Phone/Fax

Practice location:
  • Phone: 678-663-3477
  • Fax:
Mailing address:
  • Phone: 678-663-3477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number14042
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number011234
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: