Provider Demographics
NPI:1700232840
Name:KANTES, REBEKAH LYNCH (MS, CRC, LPC)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:LYNCH
Last Name:KANTES
Suffix:
Gender:F
Credentials:MS, CRC, LPC
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:
Other - Last Name:LYNCH-KANTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CR C, LPC
Mailing Address - Street 1:769 BLOODY RUN RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4796
Mailing Address - Country:US
Mailing Address - Phone:304-296-8410
Mailing Address - Fax:
Practice Address - Street 1:301 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8804
Practice Address - Country:US
Practice Address - Phone:304-296-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-08
Last Update Date:2016-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWVLPC 1022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health