Healthcare Provider Details

I. General information

NPI: 1780038646
Provider Name (Legal Business Name): RACHEL ANN DINE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL ANN HAARALA LPC

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 GREENBRIER CIR STE 209
CHESAPEAKE VA
23320-2642
US

IV. Provider business mailing address

816 GREENBRIER CIR STE 209
CHESAPEAKE VA
23320-2642
US

V. Phone/Fax

Practice location:
  • Phone: 577-397-6771
  • Fax: 757-739-6771
Mailing address:
  • Phone: 850-469-3500
  • Fax: 850-595-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14115
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701006922
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: