Provider Demographics
NPI:1053988329
Name:CARR, RACHEL C (BCABA, LABA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:CARR
Suffix:
Gender:
Credentials:BCABA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 BRAMBLETON AVE STE 201A
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6527
Mailing Address - Country:US
Mailing Address - Phone:540-266-7550
Mailing Address - Fax:
Practice Address - Street 1:3433 BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6515
Practice Address - Country:US
Practice Address - Phone:540-266-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000394106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst