Provider Demographics
NPI:1134221468
Name:YATES, RACHEL GOODMAN (PHD,LMFT)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:GOODMAN
Last Name:YATES
Suffix:
Gender:F
Credentials:PHD,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1251
Mailing Address - Street 2:
Mailing Address - City:LEAKEY
Mailing Address - State:TX
Mailing Address - Zip Code:78873-1251
Mailing Address - Country:US
Mailing Address - Phone:830-232-4343
Mailing Address - Fax:775-923-7353
Practice Address - Street 1:60 CHILDRESS LANE
Practice Address - Street 2:
Practice Address - City:LEAKEY
Practice Address - State:TX
Practice Address - Zip Code:78873
Practice Address - Country:US
Practice Address - Phone:830-232-4343
Practice Address - Fax:775-923-7353
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00916BOtherBLUE CROSS