Provider Demographics
NPI:1801262563
Name:SLOUGH-JOHNSON, RACHEL M (LMFT, SAC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:SLOUGH-JOHNSON
Suffix:
Gender:F
Credentials:LMFT, SAC
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:MARIE
Other - Last Name:SLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3800 PARK NICOLLET BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2527
Practice Address - Country:US
Practice Address - Phone:952-993-3123
Practice Address - Fax:952-993-3286
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16490431101YA0400X
WI469101YP2500X
WI1143-124106H00000X
MN4100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional