Provider Demographics
NPI:1477003499
Name:YORK, REBECCA BISWAS (LAC, LMSW, MSW U/S)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:BISWAS
Last Name:YORK
Suffix:
Gender:F
Credentials:LAC, LMSW, MSW U/S
Other - Prefix:
Other - First Name:RINI
Other - Middle Name:
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:103189 S 4720 RD
Mailing Address - Street 2:
Mailing Address - City:MULDROW
Mailing Address - State:OK
Mailing Address - Zip Code:74948-6298
Mailing Address - Country:US
Mailing Address - Phone:503-349-4391
Mailing Address - Fax:
Practice Address - Street 1:204 E CHOCTAW AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4604
Practice Address - Country:US
Practice Address - Phone:918-790-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-13
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20117104100000X
AR095171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171100000XOther Service ProvidersAcupuncturist