Provider Demographics
NPI:1053960757
Name:CORCHINE, RACHAEL LAUREN
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:LAUREN
Last Name:CORCHINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 N GRACE BLVD UNIT 100
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0606
Mailing Address - Country:US
Mailing Address - Phone:505-205-8464
Mailing Address - Fax:
Practice Address - Street 1:3377 S PRICE RD STE 110
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3578
Practice Address - Country:US
Practice Address - Phone:480-280-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23246101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor