Provider Demographics
NPI:1598593121
Name:RACHAEL GOINS LCSW, LLC
Entity type:Organization
Organization Name:RACHAEL GOINS LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:GOINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:612-791-0336
Mailing Address - Street 1:4236 N SPAULDING AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1250
Mailing Address - Country:US
Mailing Address - Phone:612-791-0336
Mailing Address - Fax:
Practice Address - Street 1:4236 N SPAULDING AVE APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1250
Practice Address - Country:US
Practice Address - Phone:612-791-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)