Provider Demographics
NPI:1487145124
Name:WILL, RASHANDA (LCPC, HHP)
Entity type:Individual
Prefix:
First Name:RASHANDA
Middle Name:
Last Name:WILL
Suffix:
Gender:F
Credentials:LCPC, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 LOOMIS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61102-2665
Mailing Address - Country:US
Mailing Address - Phone:815-329-4768
Mailing Address - Fax:
Practice Address - Street 1:1903 LOOMIS ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61102-2665
Practice Address - Country:US
Practice Address - Phone:815-329-4768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
IL180011605101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No175F00000XOther Service ProvidersNaturopath