Provider Demographics
NPI:1992475735
Name:REINISCH, RACHELLE (LMFT)
Entity type:Individual
Prefix:DR
First Name:RACHELLE
Middle Name:
Last Name:REINISCH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15180 DECEMBER TRL
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-5532
Mailing Address - Country:US
Mailing Address - Phone:812-701-8824
Mailing Address - Fax:
Practice Address - Street 1:15170 CHIPPENDALE AVE W STE 102
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-2769
Practice Address - Country:US
Practice Address - Phone:812-701-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3019106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3019OtherMARRIAGE AND FAMILY THERAPY LICENSE