Provider Demographics
NPI:1457503252
Name:ANTHONY, REBECCA S (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-623-7048
Mailing Address - Fax:302-623-7374
Practice Address - Street 1:333 N SHIPLEY ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2412
Practice Address - Country:US
Practice Address - Phone:302-552-5901
Practice Address - Fax:302-428-2121
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100009041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical