Provider Demographics
NPI:1104013267
Name:YARBROUGH, REBECCA ANN (LCPC-CC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:YARBROUGH
Suffix:
Gender:F
Credentials:LCPC-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WESTMINISTER ST.
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3350
Mailing Address - Country:US
Mailing Address - Phone:207-615-5704
Mailing Address - Fax:207-795-4140
Practice Address - Street 1:151 N. TEMPLE STREEET
Practice Address - Street 2:THOMAS J. MCMAHON ELEMENTRY SCHOOL
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3350
Practice Address - Country:US
Practice Address - Phone:207-615-5704
Practice Address - Fax:207-795-4140
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-02
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health