Provider Demographics
NPI:1447579859
Name:MEAD, REBEKAH AZRIEL (MSW)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:AZRIEL
Last Name:MEAD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 HILL DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-5412
Mailing Address - Country:US
Mailing Address - Phone:352-999-0061
Mailing Address - Fax:
Practice Address - Street 1:5509 GRAND BLVD
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-3836
Practice Address - Country:US
Practice Address - Phone:727-214-8108
Practice Address - Fax:727-494-7610
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical