Provider Demographics
NPI:1144839788
Name:FRICKE, RACHAEL ANN (LAC, LPC-MH, LPCC)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:ANN
Last Name:FRICKE
Suffix:
Gender:F
Credentials:LAC, LPC-MH, LPCC
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:ANN
Other - Last Name:MIEDEMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8016 E NORWAY PINE TRL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4047
Mailing Address - Country:US
Mailing Address - Phone:712-363-4349
Mailing Address - Fax:
Practice Address - Street 1:7511 S LOUISE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5997
Practice Address - Country:US
Practice Address - Phone:605-312-8700
Practice Address - Fax:605-312-8701
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD16091731101YA0400X
IA112727101YM0800X
SDLPC7420101YM0800X
MNCC03615101YP2500X
SDLPC-MH30593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health