Provider Demographics
NPI:1710233218
Name:RACH, NANCY JOANN (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOANN
Last Name:RACH
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 1:17420 460TH ST
Mailing Address - Street 2:
Mailing Address - City:VERNDALE
Mailing Address - State:MN
Mailing Address - Zip Code:56481-3119
Mailing Address - Country:US
Mailing Address - Phone:218-924-2372
Mailing Address - Fax:
Practice Address - Street 1:17420 460TH ST
Practice Address - Street 2:
Practice Address - City:VERNDALE
Practice Address - State:MN
Practice Address - Zip Code:56481-3119
Practice Address - Country:US
Practice Address - Phone:218-924-2372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00293101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health