Individual provider Active NPI

Rebecca Lynne Malan, MSW, LICSW, LCSW

  • Clinical Social Worker
  • West St Paul, MN
National Provider Identifier
1487774063
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
36156 Issued in MN
Practice address
149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238
Phone
(651) 450-0860
Fax
(651) 450-0759
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X 06003 TX
Social Worker 104100000X 43556 ID
Clinical Social Worker 1041C0700X 36156 MN Primary
Clinical Social Worker 1041C0700X LCSW-8911283 ID

Addresses

Primary practice location

149 Thompson Ave E Ste 150
West St Paul, MN 55118-3238

Mailing address

4240 Park Glen Rd
St Louis Park, MN 55416-5427
Phone (612) 925-6033

Other practice location 1

1675 Curlew Dr
Ammon, ID 83406-4718
Phone (208) 360-1038

Other names 1

  • Rebecca Lynne Rasche Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930001958 ID Practitioner - Clinical Social Worker 0143726117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1675 Curlew Dr
Ammon, ID 83406-4718

1675 Curlew Dr
Ammon, ID 83406-4850

PO Box
Idaho Falls, ID 83403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43556IDMDSocial Worker
LCSW-8911283IDMDClinical Social Worker
06003TXMDLay Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
4 Pillars of Success LLC Clinical CurrentSince Aug 1, 2025 Accepting new patients
4 Pillars of Success LLC Social Worker CurrentSince Aug 1, 2025 Accepting new patients
Associated Clinic of Psychology Inc PastSince Apr 24, 2018 Accepting new patients

Locations

1675 Curlew Dr
Ammon, ID 83406
Phone (208) 523-5319

1619 Curlew Dr
Ste 7
Ammon, ID 83406
Phone (208) 497-0898

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1487774063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 THOMPSON AVE E STE 150",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183238",
            "telephone_number": "651-450-0860",
            "fax_number": "651-450-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Curlew Dr",
            "address_purpose": "LOCATION",
            "city": "Ammon",
            "state": "ID",
            "postal_code": "834064718",
            "country_code": "US",
            "telephone_number": "208-360-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAN",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "TX",
            "license": "06003",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "43556",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "36156",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-8911283",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "RASCHE",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West St Paul, MN

Sources for this page

Verify at the official NPI Registry.