Provider Demographics
NPI:1619020047
Name:BEUTLER, REBECCA LYNN (EDD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNN
Last Name:BEUTLER
Suffix:
Gender:F
Credentials:EDD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 112TH AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-5903
Mailing Address - Country:US
Mailing Address - Phone:253-278-9292
Mailing Address - Fax:253-268-2021
Practice Address - Street 1:5511 112TH AVE E STE A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-5903
Practice Address - Country:US
Practice Address - Phone:253-278-9292
Practice Address - Fax:253-268-2021
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60083795101YM0800X
WARC00054134101YP2500X
WAPY60318110103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional