Provider Demographics
NPI:1730681248
Name:BROTHERS, RACHEL (LICSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2578 14 1/2 AVE SE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-9539
Mailing Address - Country:US
Mailing Address - Phone:605-520-1759
Mailing Address - Fax:
Practice Address - Street 1:128 13TH AVE SE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MN
Practice Address - Zip Code:56374-9444
Practice Address - Country:US
Practice Address - Phone:605-520-1759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MN208261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN20826OtherLICENSED INDEPENDENT CLINICAL SOCIAL WORKER