Healthcare Provider Details

I. General information

NPI: 1306674148
Provider Name (Legal Business Name): RACHEL GATLIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 MORTHLAND DR STE C
VALPARAISO IN
46385-4638
US

IV. Provider business mailing address

549 S 15TH ST
CHESTERTON IN
46304-2888
US

V. Phone/Fax

Practice location:
  • Phone: 219-200-4231
  • Fax:
Mailing address:
  • Phone: 219-617-8589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34012950A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: