Healthcare Provider Details

I. General information

NPI: 1013689710
Provider Name (Legal Business Name): RACHEL SWENSON COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2021
Last Update Date: 09/30/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 4TH ST
GAYLORD MN
55334-4443
US

IV. Provider business mailing address

33549 571ST AVE
LAFAYETTE MN
56054-3007
US

V. Phone/Fax

Practice location:
  • Phone: 507-276-9496
  • Fax:
Mailing address:
  • Phone: 507-276-9496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RACHEL L SWENSON
Title or Position: OWNER
Credential: LICSW
Phone: 507-276-9496