Healthcare Provider Details

I. General information

NPI: 1821340134
Provider Name (Legal Business Name): RACHAEL BOLTON LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL MADDEN-CONNOR

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9129 CROSS PARK DR # 100
KNOXVILLE TN
37923-4505
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7725
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-1899
  • Fax: 865-409-5948
Mailing address:
  • Phone: 833-604-3693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6932
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: