Provider Demographics
NPI:1649741927
Name:ALLEN, REBECCA LEIGH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LEIGH
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LEIGH
Other - Middle Name:A
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-0411
Mailing Address - Country:US
Mailing Address - Phone:406-885-2693
Mailing Address - Fax:406-319-2511
Practice Address - Street 1:2 6TH AVE E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-2726
Practice Address - Country:US
Practice Address - Phone:406-885-2693
Practice Address - Fax:406-319-2511
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2022-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT486761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical