Provider Demographics
NPI:1083400642
Name:BOBST, RACHEL RAELENE (MS, LPC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RAELENE
Last Name:BOBST
Suffix:
Gender:
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12560 W HIDDEN PINE LN
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-6071
Mailing Address - Country:US
Mailing Address - Phone:208-949-8218
Mailing Address - Fax:
Practice Address - Street 1:12560 W HIDDEN PINE LN
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:ID
Practice Address - Zip Code:83669-6071
Practice Address - Country:US
Practice Address - Phone:208-949-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9561775101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor