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General NPI Number Information
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NPI Number | 1720343056
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Entity Type | Individual
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Provider Name | RACHAEL FRYREAR MA, CAC III
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Gender | Female
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Dates
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Enumeration Date | 07/12/2012
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Last Update Date | 10/26/2025
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Provider Practice Location Address
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Address Line | 541 N LOGAN AVE
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City | HAXTUN
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State | CO
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Zip | 80731-2563
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Country | US
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Telephone | 970-580-7435
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Fax | 970-580-7435
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Provider Business Mailing Address
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Address Line | PO BOX 113
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City | HAXTUN
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State | CO
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Zip | 80731-0113
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Country | US
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Telephone | 970-466-5659
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Fax | 719-982-7282
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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 | CAC-6180
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License Number State | CO
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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 | 0019645
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License Number State | CO
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