Provider Demographics
NPI:1386040020
Name:STANGELAND, RACHAEL RENEE (LSCW-PIP)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:RENEE
Last Name:STANGELAND
Suffix:
Gender:F
Credentials:LSCW-PIP
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:RENEE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BACHELOR'S MHC
Mailing Address - Street 1:120 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-2311
Mailing Address - Country:US
Mailing Address - Phone:605-886-5262
Mailing Address - Fax:605-886-5228
Practice Address - Street 1:120 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-2311
Practice Address - Country:US
Practice Address - Phone:605-886-5262
Practice Address - Fax:605-886-5228
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD50481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical