Provider Demographics
NPI:1063702181
Name:BELAIR, RACHAEL SUZANNE (MSW)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:SUZANNE
Last Name:BELAIR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 CHICAGO AVE STE 2D
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4181
Mailing Address - Country:US
Mailing Address - Phone:612-217-1889
Mailing Address - Fax:612-268-0278
Practice Address - Street 1:4749 CHICAGO AVE STE 2D
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4181
Practice Address - Country:US
Practice Address - Phone:612-217-1889
Practice Address - Fax:612-268-0278
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN194271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical