Provider Demographics
NPI:1013141027
Name:BALDWIN, REBECCA GAY (LPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:GAY
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 MORRISON MOORE PKWY W
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-1422
Mailing Address - Country:US
Mailing Address - Phone:706-344-8461
Mailing Address - Fax:706-348-6065
Practice Address - Street 1:487 MORRISON MOORE PKWY W
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1422
Practice Address - Country:US
Practice Address - Phone:706-344-8461
Practice Address - Fax:706-348-6065
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional