Healthcare Provider Details

I. General information

NPI: 1760121883
Provider Name (Legal Business Name): RACHEL CHERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 SUWANNEE TRAIL ST
BOWLING GREEN KY
42103-7956
US

IV. Provider business mailing address

2782 INDUSTRIAL DR APT D2
BOWLING GREEN KY
42101-4073
US

V. Phone/Fax

Practice location:
  • Phone: 270-901-5000
  • Fax:
Mailing address:
  • Phone: 270-791-0906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number305367
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number305367
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: