Healthcare Provider Details

I. General information

NPI: 1235872292
Provider Name (Legal Business Name): RACHEL NICOLE SEVERS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10967 ALLISONVILLE RD STE 240
FISHERS IN
46038-2634
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 419-305-4702
  • Fax:
Mailing address:
  • Phone: 216-468-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20043568A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: