Provider Demographics
NPI:1073575999
Name:CHREST, ROSALIN ARDELE (LICSW)
Entity Type:Individual
Prefix:
First Name:ROSALIN
Middle Name:ARDELE
Last Name:CHREST
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ROSALIN
Other - Middle Name:ARDELE
Other - Last Name:THINGELSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 AMES CROSSING RD STE 600
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2519
Mailing Address - Country:US
Mailing Address - Phone:651-774-0011
Mailing Address - Fax:651-774-0606
Practice Address - Street 1:1930 COON RAPIDS BOULEVARD
Practice Address - Street 2:FAMILY LIFE MENTAL HEALTH CENTER
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433
Practice Address - Country:US
Practice Address - Phone:763-427-7964
Practice Address - Fax:763-427-7976
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN156501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6261828OtherUBH
168060OtherU CARE
MN288623500Medicaid
HP34501OtherHEALTH PARTNERS
1029315OtherPREFERRED ONE
MN407T9CHOtherBCBS
MN407T9CHOtherBCBS
MN800001426Medicare ID - Type Unspecified