Provider Demographics
NPI:1275801979
Name:WILLIAMS, REBEKAH MARA (PMHNP-BC)
Entity Type:Individual
Prefix:PROF
First Name:REBEKAH
Middle Name:MARA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:MARA
Other - Last Name:BROWNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1513
Mailing Address - Country:US
Mailing Address - Phone:716-373-7440
Mailing Address - Fax:
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:SUITE 4308
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1156
Practice Address - Country:US
Practice Address - Phone:716-701-3267
Practice Address - Fax:716-701-3728
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 605850163WP0808X
NYF401628-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health