Provider Demographics
NPI:1538642160
Name:MALEY, RACHEL ANN (LICSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:MALEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:HOFSCHULTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:4600 18TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901
Mailing Address - Country:US
Mailing Address - Phone:507-263-6800
Mailing Address - Fax:507-287-7805
Practice Address - Street 1:4600 18TH AVE NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-263-6800
Practice Address - Fax:507-287-7805
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN224751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN422642300Medicaid