Provider Demographics
NPI:1588044929
Name:HUTCHISON, REBECCA (LCSW-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32351 GEIB RD
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:MD
Mailing Address - Zip Code:21625-2363
Mailing Address - Country:US
Mailing Address - Phone:410-253-2824
Mailing Address - Fax:410-820-4281
Practice Address - Street 1:8221 TEAL DR STE 429
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7212
Practice Address - Country:US
Practice Address - Phone:410-253-2824
Practice Address - Fax:855-273-7002
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD153881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7521057Medicaid