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General NPI Number Information
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NPI Number | 1043638448
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Entity Type | Individual
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Provider Name | RACHAEL MARBLE LEARY MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 2424 SW PUMICE AVE
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City | REDMOND
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State | OR
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Zip | 97756-6729
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Country | US
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Telephone | 541-668-6141
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Fax | 541-236-0332
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Provider Business Mailing Address
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Address Line | 70 SW CENTURY DR STE 100-5038
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City | BEND
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State | OR
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Zip | 97702-3557
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Country | US
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Telephone | 541-668-6141
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Fax | 541-236-0332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21-12-20128
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C6420
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C6420
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License Number State | OR
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