Provider Demographics
NPI:1538530282
Name:ROUSSEAU, RACHEL FREED (MA, LMFT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:FREED
Last Name:ROUSSEAU
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 W MISSION ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2432
Mailing Address - Country:US
Mailing Address - Phone:805-330-3944
Mailing Address - Fax:
Practice Address - Street 1:26 W MISSION ST STE 4
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2432
Practice Address - Country:US
Practice Address - Phone:805-330-3944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA109062106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health