Sandra Sue Rahm, LPC

Individual provider Active NPI Professional Counselor · Boonville, MO

NPI 1386972685 · NPPES record last updated Nov 24, 2009

Key facts

NPI
1386972685
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
001772 (MO)
Practice address
413 E Spring St
Boonville, MO 65233-1573
Phone
(660) 882-6400
Fax
(660) 882-7137
NPI assigned
Nov 24, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001772MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Dynamics LLC Past
since Dec 18, 2022
Accepting new patients
Walking Peace Past
since Sep 23, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 001772 MO Yes

Addresses

Primary practice location

413 E Spring St
Boonville, MO 65233-1573

Mailing address

413 E Spring St
Boonville, MO 65233-1573
Phone (660) 882-6400

Other providers in Boonville, MO

All providers in Boonville, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.