Provider Demographics
NPI:1104853472
Name:CHEEK-KING, REBECCA L (LCP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:CHEEK-KING
Suffix:
Gender:F
Credentials:LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WAKARUSA DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4722
Mailing Address - Country:US
Mailing Address - Phone:785-856-0676
Mailing Address - Fax:785-588-4608
Practice Address - Street 1:1201 WAKARUSA DR STE 201
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4722
Practice Address - Country:US
Practice Address - Phone:785-856-0676
Practice Address - Fax:785-588-4608
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS314101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200439020AMedicaid