Provider Demographics
NPI:1316652761
Name:VAN BEEK, RACHEL M (MA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:VAN BEEK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W BASELINE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5350
Mailing Address - Country:US
Mailing Address - Phone:480-992-6914
Mailing Address - Fax:
Practice Address - Street 1:401 W BASELINE RD STE 210
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5350
Practice Address - Country:US
Practice Address - Phone:480-307-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-19
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-21766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional