MEDICARE: RACHEL S WEINSTEIN LMHC

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	:	1902567506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHEL S WEINSTEIN LMHC

Provider Business Mailing Address
First Line	:	4300 MARSH LANDING BLVD STE 204
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1420
Country	:	US
Telephone Number	:	904-658-0485
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 MARSH LANDING BLVD STE 204
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1420
Country	:	US
Telephone Number	:	904-658-0485
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL WEINSTEIN
Credential	:	LMHC
Telephone Number	:	904-651-2456

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	01/05/2022

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