Rachel Supercinski, LM, CPM, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-302710 Issued in TX

Practice address

1705 Cardinal LN
College Station, TX 77845-8178

Phone

(979) 324-8909

NPI assigned

Oct 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1245871607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CARDINAL LN",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CARDINAL LN",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458178",
            "telephone_number": "979-324-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERCINSKI",
        "first_name": "RACHEL",
        "credential": "LM, CPM, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TX",
            "license": "99538",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": "TX",
            "license": "L-302710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth J. Sullivan, M.D.
• Tara Sulser, RN
• Mark Sultenfuss, MD
• Summit Pediatrics
• Elizabeth Sunderman
• Shruti Surya, PH.D.
• Rachel Sussman
• Meagan Svec, DC
• Betty-Ann E. Svendsen, M.D.
• Wade Walker Swanson, D.O.

• Lactation Consultant (Non-RN) in College Station, TX
• Providers in College Station, TX by specialty
• Lactation Consultant (Non-RN) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.