Rachael Dawn Dudley, LCSW
Individual provider Active NPI Clinical Social Worker · Moody Afb, GA
NPI 1235100348 · NPPES record last updated Jul 29, 2025
Key facts
- NPI
- 1235100348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW003632 (GA)
- Practice address
- 3278 Mitchell Blvd
Moody Afb, GA 31699-6865 - Phone
- (229) 262-1000
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070517000064 | GA | Practitioner - Clinical Social Worker | 5294832853 | Practice locations: Valdosta, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Counseling and Consulting, LLC | Current |
Accepting new patients | |
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Livingstone a. Rasalam, M.D. P.C. | Past |
Accepting new patients |
Locations
3790 Old US Highway 41 N
Ste A
Valdosta, GA 31602
Phone (229) 262-1000
Interoperability endpoints
- rachaeldudley@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | CSW003632 | GA | Yes |
Addresses
Primary practice location
3278 Mitchell Blvd
Moody Afb, GA 31699-6865
Mailing address
3278 Mitchell Blvd
Moody Afb, GA 31699-1500
Phone (229) 257-1459
Other providers in Moody Afb, GA
- Rachel Collins
- Capri Delvaux
- George A Devita
- Konstantine Dietrich
- Mark Brian Dudley
- Melissa Marylyn Durham
- Samantha Durham
- Kendrick G Dyer
- Lashayla Teemer Dyer
- David Eric Eaton
All providers in Moody Afb, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.