Basic Information
| Provider Information | |||||||||
| NPI: | 1467776047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUDDARTH | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 REGENT PARK BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288063727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285051762 | ||||||||
| FaxNumber: | 8285051763 | ||||||||
| Practice Location | |||||||||
| Address1: | 18 REGENT PARK BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288063727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285051762 | ||||||||
| FaxNumber: | 8285051763 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2010 | ||||||||
| LastUpdateDate: | 06/13/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 7883 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.