Healthcare Provider Details

I. General information

NPI: 1659075935
Provider Name (Legal Business Name): RACHEL GUDGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 BRYAN PL SE
WASHINGTON DC
20020-4417
US

IV. Provider business mailing address

1050 NEW JERSEY AVE NW APT 710
WASHINGTON DC
20001-1349
US

V. Phone/Fax

Practice location:
  • Phone: 202-322-6171
  • Fax:
Mailing address:
  • Phone: 202-322-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: