1225834047 NPI number — RACHEL CATHERINE MCCLELLAND LPC

Table of content: RACHEL CATHERINE MCCLELLAND LPC (NPI 1225834047)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225834047 NPI number — RACHEL CATHERINE MCCLELLAND LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCLELLAND
Provider First Name:
RACHEL
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NOEL
Provider Other First Name:
RACHEL
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225834047
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3250 BUFORD HWY APT 3210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30096-3789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-980-9956
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3060 KIMBALL BRIDGE RD # 110
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30022-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-388-3909
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2025

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:  LPC015343 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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