Provider Demographics
NPI:1942015961
Name:FOUNTAIN, RACHEL REBECCA (LPC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:REBECCA
Last Name:FOUNTAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-9649
Mailing Address - Country:US
Mailing Address - Phone:409-658-0781
Mailing Address - Fax:
Practice Address - Street 1:281 W SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7052
Practice Address - Country:US
Practice Address - Phone:469-200-4093
Practice Address - Fax:469-936-2062
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional