Provider Demographics
NPI:1699107243
Name:NIESPODZANY, RACHEL L (MA; LMHC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:L
Last Name:NIESPODZANY
Suffix:
Gender:F
Credentials:MA; LMHC
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:L
Other - Last Name:BURKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA; LMHC
Mailing Address - Street 1:201 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:WI
Mailing Address - Zip Code:54162-9774
Mailing Address - Country:US
Mailing Address - Phone:920-282-9400
Mailing Address - Fax:920-282-9600
Practice Address - Street 1:201 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:WI
Practice Address - Zip Code:54162-9774
Practice Address - Country:US
Practice Address - Phone:920-282-9400
Practice Address - Fax:920-282-9600
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8374-125101Y00000X
IA087682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health