MEDICARE: RACHAEL NACHTIGAL, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1861061483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHAEL NACHTIGAL, PLLC

Provider Business Mailing Address
First Line	:	716 S MAXWELL ST
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-3658
Country	:	US
Telephone Number	:	501-607-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	716 S MAXWELL ST
Second Line	:
City	:	SILOAM SPRINGS
State	:	AR
Zip	:	72761-3658
Country	:	US
Telephone Number	:	501-607-0436
Fax Number	:	479-439-8466

Authorized Official
Title or Position	:	CLINICAL DIRECTOR/CEO
Name	:	RACHAEL MARIE NACHTIGAL
Credential	:	LPC
Telephone Number	:	501-607-0436

Provider Enumeration Date	:	06/18/2021
Last Update Date	:	06/18/2021

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