Healthcare Provider Details

I. General information

NPI: 1508771783
Provider Name (Legal Business Name): RACHAEL SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N WOOD ST
FREMONT OH
43420-2440
US

IV. Provider business mailing address

715 S BUCHANAN ST APT B
FREMONT OH
43420-4548
US

V. Phone/Fax

Practice location:
  • Phone: 567-201-2048
  • Fax: 567-280-4395
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCAPRE.196901
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: