Healthcare Provider Details

I. General information

NPI: 1447163662
Provider Name (Legal Business Name): RAFAEL PACHECO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11921 ROCKVILLE PIKE STE 402
ROCKVILLE MD
20852-2757
US

IV. Provider business mailing address

7314 HAVRE TURN
UPPER MARLBORO MD
20772-4210
US

V. Phone/Fax

Practice location:
  • Phone: 301-263-4595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4899
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: