Provider Demographics
NPI:1548737927
Name:LABRIE, REBECCA (LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LABRIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 TINKERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SALT POINT
Mailing Address - State:NY
Mailing Address - Zip Code:12578-3160
Mailing Address - Country:US
Mailing Address - Phone:203-837-6585
Mailing Address - Fax:
Practice Address - Street 1:162 TINKERTOWN RD
Practice Address - Street 2:
Practice Address - City:SALT POINT
Practice Address - State:NY
Practice Address - Zip Code:12578-3160
Practice Address - Country:US
Practice Address - Phone:203-837-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009070-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health