Provider Demographics
NPI:1639664600
Name:SCOTT, REBEKAH RENE (MA, LPC, CCTP-II)
Entity Type:Individual
Prefix:MS
First Name:REBEKAH
Middle Name:RENE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MA, LPC, CCTP-II
Other - Prefix:MRS
Other - First Name:REBEKAH
Other - Middle Name:RENE
Other - Last Name:STEARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, CCTP-II
Mailing Address - Street 1:2214 E. ELM GROVE DR.
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-7006
Mailing Address - Country:US
Mailing Address - Phone:208-573-1273
Mailing Address - Fax:208-437-7488
Practice Address - Street 1:2214 E. ELM GROVE DR.
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-7006
Practice Address - Country:US
Practice Address - Phone:208-573-1273
Practice Address - Fax:208-437-7488
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID6875101YP2500X
IDLPC-6875101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty