Provider Demographics
NPI:1306674148
Name:GATLIN, RACHEL (LSW)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:
Last Name:GATLIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:549 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2888
Mailing Address - Country:US
Mailing Address - Phone:219-617-8589
Mailing Address - Fax:
Practice Address - Street 1:101 BEVERLY DR STE A
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-3471
Practice Address - Country:US
Practice Address - Phone:219-690-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33007950A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker