Healthcare Provider Details

I. General information

NPI: 1588257778
Provider Name (Legal Business Name): RACHEL L THORNBURG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 111
DRYBRANCH WV
25061-0111
US

IV. Provider business mailing address

PO BOX 111
DRYBRANCH WV
25061-0111
US

V. Phone/Fax

Practice location:
  • Phone: 208-695-4741
  • Fax:
Mailing address:
  • Phone: 208-695-4741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-7682
License Number StateID

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: