Basic Information
Provider Information
NPI: 1447525936
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIES
FirstName: RACHEL
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: LMFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 509 E ELM ST
Address2:  
City: SALINA
State: KS
PostalCode: 674012353
CountryCode: US
TelephoneNumber: 7858250541
FaxNumber: 7858250062
Practice Location
Address1: 205 S 4TH ST
Address2: SUITE G
City: MANHATTAN
State: KS
PostalCode: 665026166
CountryCode: US
TelephoneNumber: 7855878818
FaxNumber: 7855878946
Other Information
ProviderEnumerationDate: 03/15/2012
LastUpdateDate: 03/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X2359KSY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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