Provider Demographics
NPI:1316045982
Name:LOEHRER, REBECCA K (PHD, LCP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:K
Last Name:LOEHRER
Suffix:
Gender:F
Credentials:PHD, LCP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:KEYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCP
Mailing Address - Street 1:22 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-4415
Mailing Address - Country:US
Mailing Address - Phone:540-230-8554
Mailing Address - Fax:540-639-3683
Practice Address - Street 1:22 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-4415
Practice Address - Country:US
Practice Address - Phone:540-230-8554
Practice Address - Fax:540-639-3683
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003109103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006573N01Medicare ID - Type Unspecified