Provider Demographics
NPI:1245778083
Name:MCCABE, REBECCA E (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:E
Last Name:MCCABE
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:BECCA
Other - Middle Name:
Other - Last Name:MCCABE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPCC
Mailing Address - Street 1:881 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6139
Mailing Address - Country:US
Mailing Address - Phone:507-225-0450
Mailing Address - Fax:507-779-7182
Practice Address - Street 1:881 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6139
Practice Address - Country:US
Practice Address - Phone:507-225-0450
Practice Address - Fax:507-779-7182
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1433101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1245778083Medicaid