Provider Demographics
NPI:1033351259
Name:TOMSHACK, RACHEL ELIZABETH (LPC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:TOMSHACK
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 1:3644 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-2941
Mailing Address - Country:US
Mailing Address - Phone:316-249-2313
Mailing Address - Fax:
Practice Address - Street 1:3644 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-2941
Practice Address - Country:US
Practice Address - Phone:316-249-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional