Provider Demographics
NPI:1407540362
Name:STEINBACH, REBECCA (SAC-IT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STEINBACH
Suffix:
Gender:F
Credentials:SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 S AVON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555-1309
Mailing Address - Country:US
Mailing Address - Phone:715-820-1162
Mailing Address - Fax:
Practice Address - Street 1:285 S AVON AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPS
Practice Address - State:WI
Practice Address - Zip Code:54555-1309
Practice Address - Country:US
Practice Address - Phone:715-820-1162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19187-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)