Provider Demographics
NPI:1821676784
Name:PHIPPS, REBEKAH (ACMHC)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E 900 S STE 12
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-4267
Mailing Address - Country:US
Mailing Address - Phone:828-772-4142
Mailing Address - Fax:
Practice Address - Street 1:145 E 900 S STE 6
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-4241
Practice Address - Country:US
Practice Address - Phone:828-772-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11352946-6009101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor