Provider Demographics
NPI:1164858692
Name:FELTS, REBECCA (MSW, LISW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:FELTS
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SCHEEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2500 E FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3464
Mailing Address - Country:US
Mailing Address - Phone:626-993-3000
Mailing Address - Fax:626-656-4165
Practice Address - Street 1:529 E STROOP RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-3245
Practice Address - Country:US
Practice Address - Phone:937-294-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OHI.17006501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program