Provider Demographics
NPI:1760091870
Name:BARUTH, REBECCA (PLMHP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BARUTH
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:BARUTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPD
Mailing Address - Street 1:2106 SAVANNAH DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-3327
Mailing Address - Country:US
Mailing Address - Phone:402-540-5347
Mailing Address - Fax:
Practice Address - Street 1:8790 F ST STE 206
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1534
Practice Address - Country:US
Practice Address - Phone:402-819-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12176101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health