Provider Demographics
NPI:1245246834
Name:AHLFORS, REBECCA (LMHC, PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:AHLFORS
Suffix:
Gender:F
Credentials:LMHC, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SOUTHBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2039
Mailing Address - Country:US
Mailing Address - Phone:508-762-3019
Mailing Address - Fax:508-438-1490
Practice Address - Street 1:40 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2039
Practice Address - Country:US
Practice Address - Phone:508-762-3019
Practice Address - Fax:508-438-1490
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5703101Y00000X
MA9605103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA101Y00000XOtherCOUNSELOR