Healthcare Provider Details

I. General information

NPI: 1104206150
Provider Name (Legal Business Name): RACHAEL PARSONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2084 MAIN ST
WILLISBURG KY
40078-8199
US

IV. Provider business mailing address

PO BOX 188
WILLISBURG KY
40078-0188
US

V. Phone/Fax

Practice location:
  • Phone: 859-375-9200
  • Fax: 859-375-9202
Mailing address:
  • Phone: 859-375-9200
  • Fax: 859-375-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCCCA0019
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: