Provider Demographics
NPI:1386197390
Name:MELDE-RAHE, ANN CLARE (MS, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CLARE
Last Name:MELDE-RAHE
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 FARMSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-8836
Mailing Address - Country:US
Mailing Address - Phone:608-449-2162
Mailing Address - Fax:612-445-0011
Practice Address - Street 1:9000 QUANTRELLE AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-1022
Practice Address - Country:US
Practice Address - Phone:612-217-2611
Practice Address - Fax:612-445-0011
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1969101YM0800X, 101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health