Healthcare Provider Details

I. General information

NPI: 1538464888
Provider Name (Legal Business Name): RASHA STEPHENS KOWALEWSKI LADC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2011
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 STOUGHTON AVE
CHASKA MN
55318-2149
US

IV. Provider business mailing address

500 MARSCHALL RD STE 300
SHAKOPEE MN
55379-2690
US

V. Phone/Fax

Practice location:
  • Phone: 952-856-3932
  • Fax: 952-448-6047
Mailing address:
  • Phone: 528-563-9329
  • Fax: 952-448-6047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number302825
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC2087
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: