Provider Demographics
NPI:1871224139
Name:PRICE, REBECCA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 SETON HALL CT
Mailing Address - Street 2:
Mailing Address - City:VALLEY PARK
Mailing Address - State:MO
Mailing Address - Zip Code:63088-2319
Mailing Address - Country:US
Mailing Address - Phone:314-229-0932
Mailing Address - Fax:
Practice Address - Street 1:444 SETON HALL CT
Practice Address - Street 2:
Practice Address - City:TWIN OAKS
Practice Address - State:MO
Practice Address - Zip Code:63088-2319
Practice Address - Country:US
Practice Address - Phone:314-229-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200328071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical