Healthcare Provider Details

I. General information

NPI: 1679275689
Provider Name (Legal Business Name): RACHEL RENAE BIESEMEYER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S MONROE AVE
COVINGTON VA
24426-1635
US

IV. Provider business mailing address

105 YELLOW BRICK RD
MAXWELTON WV
24957
US

V. Phone/Fax

Practice location:
  • Phone: 540-965-2100
  • Fax: 540-965-2105
Mailing address:
  • Phone: 540-353-9943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701012331
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701012331
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: