Provider Demographics
NPI:1770641987
Name:CHARNECO, REBECCA HILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HILL
Last Name:CHARNECO
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:11204 WAPLES MILL RD BLDG SUITE305
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6036
Mailing Address - Country:US
Mailing Address - Phone:703-218-8500
Mailing Address - Fax:703-359-0463
Practice Address - Street 1:4001 FAIR RIDGE DR
Practice Address - Street 2:FAIR OAKS MEDICAL BUILDING, SUITE 305
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2917
Practice Address - Country:US
Practice Address - Phone:703-992-4490
Practice Address - Fax:703-830-1847
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2021-05-25
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810002761103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA31-1822490OtherTAX IDENTIFICATION