Provider Demographics
NPI:1003054891
Name:CLINTON, REBECCA MAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MAY
Last Name:CLINTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MAY
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6370 BOSCOMB PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-2106
Mailing Address - Country:US
Mailing Address - Phone:405-474-9630
Mailing Address - Fax:
Practice Address - Street 1:6370 BOSCOMB PL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-2106
Practice Address - Country:US
Practice Address - Phone:405-474-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical