Provider Demographics
NPI:1609282029
Name:BECKER, REBECCA CLARK (LCPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLARK
Last Name:BECKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CLARK
Other - Last Name:BROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:2163 SHUBERT AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5715
Mailing Address - Country:US
Mailing Address - Phone:702-984-0559
Mailing Address - Fax:
Practice Address - Street 1:170 S. GREEN VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012
Practice Address - Country:US
Practice Address - Phone:702-984-0559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health