Provider Demographics
NPI:1992424535
Name:VOGLESONG, RACHEL NICOLE (MA, LPC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:VOGLESONG
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:NICOLE
Other - Last Name:RIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:6237 APPLEGROVE LN
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-9022
Mailing Address - Country:US
Mailing Address - Phone:312-351-0330
Mailing Address - Fax:
Practice Address - Street 1:614 ROMENCE RD STE 245
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-3613
Practice Address - Country:US
Practice Address - Phone:269-615-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional