MEDICARE: LAWRENCE RAKHMANOV LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073042057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE RAKHMANOV LCPC

Provider Business Mailing Address
First Line	:	3525 ELLICOTT MILLS DR STE G
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4638
Country	:	US
Telephone Number	:	301-778-4431
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 ELLICOTT MILLS DR STE G
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4638
Country	:	US
Telephone Number	:	410-988-8092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	02/05/2026

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