Provider Demographics
NPI:1154481679
Name:ADLER, REBECCA YODER (LICSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:YODER
Last Name:ADLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERRIMAC STREET
Mailing Address - Street 2:SUITE 17
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950
Mailing Address - Country:US
Mailing Address - Phone:978-465-7900
Mailing Address - Fax:978-463-0009
Practice Address - Street 1:1 MERRIMAC STREET
Practice Address - Street 2:SUITE 17
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950
Practice Address - Country:US
Practice Address - Phone:978-463-3030
Practice Address - Fax:978-463-0009
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1016141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P20495Medicare ID - Type Unspecified