Provider Demographics
NPI:1366634636
Name:WEBSTER, REBECCA D (MED, LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:D
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18735 NE 23RD ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:HARRAH
Mailing Address - State:OK
Mailing Address - Zip Code:73045-8130
Mailing Address - Country:US
Mailing Address - Phone:405-454-2121
Mailing Address - Fax:405-454-2121
Practice Address - Street 1:18735 NE 23RD ST
Practice Address - Street 2:SUITE E
Practice Address - City:HARRAH
Practice Address - State:OK
Practice Address - Zip Code:73045-8130
Practice Address - Country:US
Practice Address - Phone:405-454-2121
Practice Address - Fax:405-454-2121
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health