MEDICARE: RACHEL LOREN GUY LCPC, ATR

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	101YP2500X	Professional Counselor	180.103941	IL

General Provider Information

NPI Number	:	1598425860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LOREN GUY LCPC, ATR

Provider Business Mailing Address
First Line	:	2144 W POTOMAC AVE APT 1F
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3010
Country	:	US
Telephone Number	:	260-494-0217
Fax Number	:

Provider Business Practice Location Address
First Line	:	1616 N DAMEN AVE UNIT 301
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-5536
Country	:	US
Telephone Number	:	312-761-4720
Fax Number	:

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

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	12/28/2021

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