Provider Demographics
NPI:1720215973
Name:REBECCA L. WITHROW
Entity Type:Organization
Organization Name:REBECCA L. WITHROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CBRS PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WITHROW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, ITFS
Authorized Official - Phone:828-253-7592
Mailing Address - Street 1:33 WOODROW AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1701
Mailing Address - Country:US
Mailing Address - Phone:828-253-7592
Mailing Address - Fax:828-253-7592
Practice Address - Street 1:33 WOODROW AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1701
Practice Address - Country:US
Practice Address - Phone:828-253-7592
Practice Address - Fax:828-253-7592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty