Provider Demographics
NPI:1164900916
Name:CHAD, REBECCA H (PHD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:H
Last Name:CHAD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 35TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2538
Mailing Address - Country:US
Mailing Address - Phone:917-284-8617
Mailing Address - Fax:
Practice Address - Street 1:224 W 35TH ST STE 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2538
Practice Address - Country:US
Practice Address - Phone:917-284-8617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025505103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical