Provider Demographics
NPI:1447011358
Name:DIZIKI, RACHEL (LPC)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:DIZIKI
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 1:229 INDIAN ROCK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2626
Mailing Address - Country:US
Mailing Address - Phone:267-574-1190
Mailing Address - Fax:
Practice Address - Street 1:229 INDIAN ROCK DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2626
Practice Address - Country:US
Practice Address - Phone:267-574-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional