Healthcare Provider Details

I. General information

NPI: 1972951994
Provider Name (Legal Business Name): RACHEL DEBURAHA ROBERTS M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2016
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 BINGLE RD APT 322
HOUSTON TX
77092-2181
US

IV. Provider business mailing address

5550 BINGLE RD APT 322
HOUSTON TX
77092-2181
US

V. Phone/Fax

Practice location:
  • Phone: 405-550-3839
  • Fax:
Mailing address:
  • Phone: 405-550-3839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6750
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1349
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number95012
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: