Healthcare Provider Details

I. General information

NPI: 1598154106
Provider Name (Legal Business Name): RACHEL MILLSOP LPCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EUBANK BLVD NE
ALBUQUERQUE NM
87112-5314
US

IV. Provider business mailing address

1200 EUBANK BLVD NE
ALBUQUERQUE NM
87112-5314
US

V. Phone/Fax

Practice location:
  • Phone: 505-271-5050
  • Fax:
Mailing address:
  • Phone: 505-271-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009838
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0201261
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: