Healthcare Provider Details

I. General information

NPI: 1750835914
Provider Name (Legal Business Name): RACHEL COBLENTZ LMHC, CPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9018 NE 92ND ST
VANCOUVER WA
98662-2084
US

IV. Provider business mailing address

9018 NE 92ND ST
VANCOUVER WA
98662-2084
US

V. Phone/Fax

Practice location:
  • Phone: 503-410-3029
  • Fax:
Mailing address:
  • Phone: 702-688-9367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.61447399
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCP5229
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: