Provider Demographics
NPI:1083963730
Name:SWAN, RACHEL ELISABETH (LMHC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELISABETH
Last Name:SWAN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3846 E MARLENE DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1874
Mailing Address - Country:US
Mailing Address - Phone:425-502-0300
Mailing Address - Fax:
Practice Address - Street 1:6100 SW 76TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5002
Practice Address - Country:US
Practice Address - Phone:928-414-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60787753101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health