Provider Demographics
NPI:1497321699
Name:LEROY, REBECCA SUSANNE (MSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUSANNE
Last Name:LEROY
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 1:3447 NE QUINAULT DR
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9686
Mailing Address - Country:US
Mailing Address - Phone:360-440-1923
Mailing Address - Fax:
Practice Address - Street 1:2901 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4614
Practice Address - Country:US
Practice Address - Phone:253-534-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical