Provider Demographics
NPI:1306204607
Name:PADBERG, REBECCA KATHRYN (LCMHC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:KATHRYN
Last Name:PADBERG
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 BALMER ST
Mailing Address - Street 2:BLDG 547
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056-5012
Mailing Address - Country:US
Mailing Address - Phone:801-777-1629
Mailing Address - Fax:801-777-4490
Practice Address - Street 1:7309 BALMER ST
Practice Address - Street 2:BLDG 547
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-1629
Practice Address - Fax:801-777-4490
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7671959-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health