Provider Demographics
NPI:1174669964
Name:HUTCHINSON, RACHELLE DINET (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:DINET
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 CRUSE RD STE 2601
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7148
Mailing Address - Country:US
Mailing Address - Phone:770-925-2095
Mailing Address - Fax:770-277-0773
Practice Address - Street 1:2775 CRUSE RD STE 901
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7143
Practice Address - Country:US
Practice Address - Phone:770-925-2095
Practice Address - Fax:866-468-1886
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW003550104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty