Provider Demographics
NPI:1194131466
Name:WARD, RACHEAL (MA, LPC)
Entity type:Individual
Prefix:
First Name:RACHEAL
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:RACHEAL
Other - Middle Name:
Other - Last Name:CLYBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, PLPC
Mailing Address - Street 1:2981 KANELL BLVD
Mailing Address - Street 2:FAMILY COUNSELING CENTER, INC.
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901
Mailing Address - Country:US
Mailing Address - Phone:573-686-1200
Mailing Address - Fax:573-686-1029
Practice Address - Street 1:3001 WARRIOR LANE
Practice Address - Street 2:FAMILY COUNSELING CENTER, INC.
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901
Practice Address - Country:US
Practice Address - Phone:573-686-1200
Practice Address - Fax:573-686-1029
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health