Provider Demographics
NPI:1124029251
Name:RACHLIN, DANIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:RACHLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 HILLCREST DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5064
Mailing Address - Country:US
Mailing Address - Phone:931-542-6463
Mailing Address - Fax:931-542-6464
Practice Address - Street 1:130 HILLCREST DR
Practice Address - Street 2:SUITE 107
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5000
Practice Address - Country:US
Practice Address - Phone:931-553-8500
Practice Address - Fax:931-553-8544
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2472103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4040536OtherBLUE CROSS BLUE SHIELD
TN271312000OtherMAGELLAN BEHAVIORAL