Provider Demographics
NPI:1124827498
Name:CHRISTIE, RACHELLE (BS, LADC)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:CHRISTIE
Suffix:
Gender:
Credentials:BS, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55355-1802
Mailing Address - Country:US
Mailing Address - Phone:612-413-0325
Mailing Address - Fax:
Practice Address - Street 1:324 E 5TH ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55355-1802
Practice Address - Country:US
Practice Address - Phone:612-413-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN307049103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)