1194499350 NPI number — RACHEL MICHELLE ARCHER MA, LPC

Table of content: RACHEL MICHELLE ARCHER MA, LPC (NPI 1194499350)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194499350 NPI number — RACHEL MICHELLE ARCHER MA, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARCHER
Provider First Name:
RACHEL
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JACOBSEN
Provider Other First Name:
RACHEL
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, LPCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194499350
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/26/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1837 AUSTIN BLUFFS PKWY STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80918-7800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-503-5875
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1837 AUSTIN BLUFFS PKWY STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80918-7800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-344-9438
Provider Business Practice Location Address Fax Number:
719-313-9665
Provider Enumeration Date:
08/02/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  LPC.0019236 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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