Provider Demographics
NPI:1730428384
Name:GLICK, RACHEL (LMHC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GLICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 BONNIE BRAE PL
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1930
Mailing Address - Country:US
Mailing Address - Phone:206-354-5331
Mailing Address - Fax:
Practice Address - Street 1:703 BONNIE BRAE PL
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1930
Practice Address - Country:US
Practice Address - Phone:206-354-5331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60536322101YM0800X
WAMC60235261101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health