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General NPI Number Information
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NPI Number | 1215469101
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Entity Type | Individual
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Provider Name | RACHEL GLENN BOREM LPC
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Gender | Female
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 11/10/2023
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Provider Practice Location Address
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Address Line | 68 POINTE CIR STE 3201
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City | GREENVILLE
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State | SC
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Zip | 29615-6307
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | 7900 MCCLOUD RD STE 101
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City | GREENSBORO
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State | NC
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Zip | 27409-3232
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Country | US
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Telephone | 336-931-1812
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A12218
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9180
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License Number State | SC
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