Provider Demographics
NPI:1366779308
Name:PHILLIPS, RACHEAL MARIE (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:RACHEAL
Middle Name:MARIE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 SMOKY MOUNTAINS DR
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-4281
Mailing Address - Country:US
Mailing Address - Phone:615-904-5581
Mailing Address - Fax:
Practice Address - Street 1:1550 N MOUNT JULIET RD STE 118
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3786
Practice Address - Country:US
Practice Address - Phone:615-200-8477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000003579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health