Provider Demographics
NPI:1710371406
Name:GIELOW, REBECCA (LCPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GIELOW
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 WHITMIRE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61109-6732
Mailing Address - Country:US
Mailing Address - Phone:847-401-4539
Mailing Address - Fax:
Practice Address - Street 1:2518 WHITMIRE DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61109-6732
Practice Address - Country:US
Practice Address - Phone:847-401-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.0008569101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional