Provider Demographics
NPI:1629438627
Name:ALLRED, REBECCA LYNNE BROOKS (LPCA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNNE BROOKS
Last Name:ALLRED
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 ARCHIBALD RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-8884
Mailing Address - Country:US
Mailing Address - Phone:704-425-4306
Mailing Address - Fax:
Practice Address - Street 1:2620 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-7457
Practice Address - Country:US
Practice Address - Phone:980-581-8144
Practice Address - Fax:980-581-8148
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional