Provider Demographics
NPI:1437657756
Name:CHILLEMI, REBEKAH DAWN (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:DAWN
Last Name:CHILLEMI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 SW BRIGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-6070
Mailing Address - Country:US
Mailing Address - Phone:609-922-2334
Mailing Address - Fax:
Practice Address - Street 1:901 SW MARTIN DOWNS BLVD STE 200A
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-2860
Practice Address - Country:US
Practice Address - Phone:772-210-4697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101YM0800XOtherSUPER BILLS