Provider Demographics
NPI:1346599503
Name:LINCOLN, REBECCA ELIZABETH (LPC-S)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14665 FM 849
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-2440
Mailing Address - Country:US
Mailing Address - Phone:512-589-9822
Mailing Address - Fax:949-577-4252
Practice Address - Street 1:14665 FM 849
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-2440
Practice Address - Country:US
Practice Address - Phone:512-589-9822
Practice Address - Fax:903-593-9865
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17816OtherTEXAS LPC-S LICENSE
12455293OtherCAQH