Provider Demographics
NPI:1730478124
Name:TENACE, REBECCA (MS, CRC, LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TENACE
Suffix:
Gender:F
Credentials:MS, CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOHAWK
Mailing Address - State:NY
Mailing Address - Zip Code:13407-1532
Mailing Address - Country:US
Mailing Address - Phone:315-272-8732
Mailing Address - Fax:315-866-9093
Practice Address - Street 1:54 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOHAWK
Practice Address - State:NY
Practice Address - Zip Code:13407-1532
Practice Address - Country:US
Practice Address - Phone:315-272-8732
Practice Address - Fax:315-866-9093
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health