Provider Demographics
NPI:1659025732
Name:VOGELSANG, REBECCA LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LAUREN
Last Name:VOGELSANG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 SUNDOWN CT UNIT 2C
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-2757
Mailing Address - Country:US
Mailing Address - Phone:301-943-2058
Mailing Address - Fax:
Practice Address - Street 1:130 CARRIEBROOKE DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655-6000
Practice Address - Country:US
Practice Address - Phone:540-486-4653
Practice Address - Fax:540-486-4709
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040136931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
-OtherN/A