Provider Demographics
NPI:1235725763
Name:SCHALL, REBECCA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SCHALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17121 HIGHWAY 69 S
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-8091
Mailing Address - Country:US
Mailing Address - Phone:903-702-5139
Mailing Address - Fax:
Practice Address - Street 1:17121 HIGHWAY 69 S
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-8091
Practice Address - Country:US
Practice Address - Phone:903-702-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81282101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional