Provider Demographics
NPI:1407228570
Name:THIPSINGH, REBECCA (LCSW, TCT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:THIPSINGH
Suffix:
Gender:F
Credentials:LCSW, TCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4561 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-6737
Mailing Address - Country:US
Mailing Address - Phone:561-281-8846
Mailing Address - Fax:
Practice Address - Street 1:391 COMMERCE PKWY STE 220
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4209
Practice Address - Country:US
Practice Address - Phone:321-258-9537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW15583101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103651200Medicaid