MEDICARE: RACHEL RADANDT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	6401224270	MI

General Provider Information

NPI Number	:	1932843323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL RADANDT

Provider Business Mailing Address
First Line	:	260 WESTRIDGE DR
Second Line	:
City	:	SOMERS
State	:	MT
Zip	:	59932-9700
Country	:	US
Telephone Number	:	406-407-2396
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 2ND ST E STE 204
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-4500
Country	:	US
Telephone Number	:	406-407-2396
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	06/17/2024

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Directions to “ RACHEL RADANDT ” Practice Location

Language	Start Address	Practice Location

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