Provider Demographics
NPI:1619275757
Name:JAMES, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:BRUEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:157 EASTERN AVE APT 203
Mailing Address - Street 2:157 EASTERN AVE APT 203
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4646
Mailing Address - Country:US
Mailing Address - Phone:603-703-3710
Mailing Address - Fax:
Practice Address - Street 1:157 EASTERN AVE
Practice Address - Street 2:#203
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-4644
Practice Address - Country:US
Practice Address - Phone:603-703-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-13
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH818101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health