Provider Demographics
NPI:1427007186
Name:STILLING, REBECCA (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:STILLING
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 HOUMA BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2531
Mailing Address - Country:US
Mailing Address - Phone:504-888-0727
Mailing Address - Fax:504-888-0727
Practice Address - Street 1:4902 CANAL ST
Practice Address - Street 2:SUITE 404
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5840
Practice Address - Country:US
Practice Address - Phone:504-482-8409
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA572106H00000X
LA15441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X742Medicare ID - Type Unspecified