Individual
MS. RACHEL LACY WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,M.ED
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Mailing address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 863-1132
(228) 865-1700
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
816
MS
101YS0200X
School Counselor
Primary
816
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018213
—
MS
Enumeration date
07/19/2006
Last updated
09/11/2025
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