Provider Demographics
NPI:1740648575
Name:BOUGALIS, RACHEL MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:BOUGALIS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:FOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1880 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-4085
Mailing Address - Country:US
Mailing Address - Phone:218-208-2233
Mailing Address - Fax:218-246-9849
Practice Address - Street 1:1880 RIVER RD
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4085
Practice Address - Country:US
Practice Address - Phone:218-208-2233
Practice Address - Fax:218-246-9849
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC01132101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional