Provider Demographics
NPI:1013689710
Name:RACHEL SWENSON COUNSELING LLC
Entity Type:Organization
Organization Name:RACHEL SWENSON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:507-276-9496
Mailing Address - Street 1:33549 571ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:MN
Mailing Address - Zip Code:56054-3007
Mailing Address - Country:US
Mailing Address - Phone:507-276-9496
Mailing Address - Fax:
Practice Address - Street 1:230 4TH ST
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MN
Practice Address - Zip Code:55334-4443
Practice Address - Country:US
Practice Address - Phone:507-276-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1346535796Medicaid