Provider Demographics
NPI:1699935544
Name:ANDERSON, RACHAEL ELAINE (MS, LPC)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ELAINE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ELAINE
Other - Last Name:HARTWILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:10936 DECOY LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-7919
Mailing Address - Country:US
Mailing Address - Phone:804-651-2070
Mailing Address - Fax:804-744-7678
Practice Address - Street 1:3900 MONUMENT AVE
Practice Address - Street 2:SUITE F
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3955
Practice Address - Country:US
Practice Address - Phone:804-651-2070
Practice Address - Fax:804-744-7678
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004359101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional