Provider Demographics
NPI:1205216892
Name:ENSIGN, REBECCA J (MA, LCMHC, LCPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:ENSIGN
Suffix:
Gender:F
Credentials:MA, LCMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 S RIVER RD STE 1
Mailing Address - Street 2:#1001
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6774
Mailing Address - Country:US
Mailing Address - Phone:603-718-3330
Mailing Address - Fax:
Practice Address - Street 1:85 S RIVER RD STE 1
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6774
Practice Address - Country:US
Practice Address - Phone:603-718-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2343101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health