Provider Demographics
NPI:1649571134
Name:HUBER, REBECCA WELLS (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:WELLS
Last Name:HUBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:WELLS
Other - Last Name:PINKHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1359 PARKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2114
Mailing Address - Country:US
Mailing Address - Phone:610-388-1943
Mailing Address - Fax:
Practice Address - Street 1:5201 WASHINGTON STREET EXT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2156
Practice Address - Country:US
Practice Address - Phone:302-765-1100
Practice Address - Fax:302-765-1107
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00006911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical