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NPI Code Detail

MEDICARE: MRS. RACHEL RENEE PAVLOV LPC, LCDC

MEDICARE: MRS. RACHEL RENEE PAVLOV LPC, LCDC
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
1101YM0800XMental Health Counselor90531TX
2101YA0400XAddiction (Substance Use Disorder) Counselor16312TX

General Provider Information

NPI Number : 1225726557
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RACHEL RENEE PAVLOV LPC, LCDC
Provider Business Mailing Address
First Line : 1400 N CORINTH ST STE 109
Second Line :
City : CORINTH
State : TX
Zip : 76208-5444
Country : US
Telephone Number : 940-448-0304
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N CORINTH ST STE 109
Second Line :
City : CORINTH
State : TX
Zip : 76208-5444
Country : US
Telephone Number : 940-448-0304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2023
Last Update Date : 06/29/2024

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