Provider Demographics
NPI:1497820591
Name:WESTERBEEK, REBEKAH YODER (LCSW)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:YODER
Last Name:WESTERBEEK
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 1:1030 MINERS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085
Mailing Address - Country:US
Mailing Address - Phone:269-408-1688
Mailing Address - Fax:
Practice Address - Street 1:1030 MINERS RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085
Practice Address - Country:US
Practice Address - Phone:269-408-1688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010907531041C0700X
IN34005649A1041C0700X
TN47871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4787OtherLCSW LICENSE
IN34005649AOtherLCSW LICENSE
MI6801090753OtherLMSW LICENSE
TN3987757Medicare PIN