Provider Demographics
NPI:1356641740
Name:HARGIS, REBECCA A (LCPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:A
Last Name:HARGIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2023
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-2023
Mailing Address - Country:US
Mailing Address - Phone:406-459-0380
Mailing Address - Fax:406-442-0248
Practice Address - Street 1:616 HELENA AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3654
Practice Address - Country:US
Practice Address - Phone:406-443-4730
Practice Address - Fax:406-442-0248
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1520101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor