Healthcare Provider Details

I. General information

NPI: 1073430617
Provider Name (Legal Business Name): RACHEL LYN GUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 W 16TH ST STE 2800
INDIANAPOLIS IN
46202-2279
US

IV. Provider business mailing address

355 W 16TH ST STE 2800
INDIANAPOLIS IN
46202-2279
US

V. Phone/Fax

Practice location:
  • Phone: 317-963-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number20044084A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS01818
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20044084A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: