Provider Demographics
NPI:1073081634
Name:GEORGE, REBEKAH (LMHC)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-3734
Mailing Address - Country:US
Mailing Address - Phone:317-431-6819
Mailing Address - Fax:
Practice Address - Street 1:105 HOWARD RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-3734
Practice Address - Country:US
Practice Address - Phone:317-431-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003337A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health