Provider Demographics
NPI:1447034434
Name:EDINGTON, RACHEL (PCLC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:EDINGTON
Suffix:
Gender:F
Credentials:PCLC
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 478
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-0478
Mailing Address - Country:US
Mailing Address - Phone:406-813-1192
Mailing Address - Fax:
Practice Address - Street 1:36673 FAIR MEADOW LN
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-7264
Practice Address - Country:US
Practice Address - Phone:406-201-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-APP-64418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health