Provider Demographics
NPI:1518221183
Name:GOLDSTEIN, REBECCA (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 CARPENTER ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-2515
Mailing Address - Country:US
Mailing Address - Phone:484-800-1747
Mailing Address - Fax:
Practice Address - Street 1:121 N WAYNE AVE STE 300
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3542
Practice Address - Country:US
Practice Address - Phone:484-800-1747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008053101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health