Provider Demographics
NPI:1245021815
Name:YORK, REBEKAH (BCBA)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:YORK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 OLD MINDEN RD STE 21
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-4846
Mailing Address - Country:US
Mailing Address - Phone:318-789-7239
Mailing Address - Fax:
Practice Address - Street 1:1701 OLD MINDEN RD STE 21
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-4846
Practice Address - Country:US
Practice Address - Phone:318-789-7239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-983103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst