Provider Demographics
NPI:1235992405
Name:REAN, REBECCA GENEVIEVE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:GENEVIEVE
Last Name:REAN
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 1:41 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4219
Mailing Address - Country:US
Mailing Address - Phone:732-639-1486
Mailing Address - Fax:
Practice Address - Street 1:41 PARK BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4219
Practice Address - Country:US
Practice Address - Phone:732-639-1486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01005100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional