Provider Demographics
NPI:1871841619
Name:MATHEWS, REBEKKA FAYE
Entity Type:Individual
Prefix:MS
First Name:REBEKKA
Middle Name:FAYE
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 KILDAIRE FARM RD
Mailing Address - Street 2:SUITE 135 PMB 545
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-2278
Mailing Address - Country:US
Mailing Address - Phone:919-459-7221
Mailing Address - Fax:
Practice Address - Street 1:3434 KILDAIRE FARM RD
Practice Address - Street 2:SUITE 135 PMB 545
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-2278
Practice Address - Country:US
Practice Address - Phone:919-459-7221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS12330101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty