Provider Demographics
NPI:1891386108
Name:VOELKER, RACHAEL (LMFT)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:VOELKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 TRACE CT
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-5296
Mailing Address - Country:US
Mailing Address - Phone:423-765-7816
Mailing Address - Fax:
Practice Address - Street 1:1936 BROOKSIDE DR STE E
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4654
Practice Address - Country:US
Practice Address - Phone:142-376-5077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1680101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1680OtherBOARD FOR LICENSED PROFESSIONAL COUNSELORS, LICENSED MARITAL AND FAMILY THERAPIS