Individual provider Active NPI

Rachel Hartman, LCACA

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1477265064
Registry record updated Jun 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005449A Issued in IN
Practice address
11030 Hickory Tree Rd
Fort Wayne, IN 46845-1034
Phone
(260) 750-6369
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39005449A IN Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 87900012A IN

Addresses

Primary practice location

11030 Hickory Tree Rd
Fort Wayne, IN 46845-1034

Mailing address

11030 Hickory Tree Rd
Fort Wayne, IN 46845-1034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
87900012AINMDAddiction (Substance Use Disorder) Counselor
39005449AINMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751155200000",
    "number": "1477265064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11030 HICKORY TREE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11030 HICKORY TREE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451034",
            "telephone_number": "260-750-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "RACHEL",
        "credential": "LCACA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2025-06-29",
        "certification_date": "2025-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005449A",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87900012A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.