Provider Demographics
NPI:1871822460
Name:METZGER, REBECCA ANN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:METZGER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 W CARMEL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5877
Mailing Address - Country:US
Mailing Address - Phone:317-569-5433
Mailing Address - Fax:317-569-1767
Practice Address - Street 1:755 W CARMEL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5877
Practice Address - Country:US
Practice Address - Phone:317-569-5433
Practice Address - Fax:317-569-1767
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006098A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200939800AMedicaid