Provider Demographics
NPI:1265199327
Name:ENCINAS, REBECCA ALICE (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALICE
Last Name:ENCINAS
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:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:NEW KNOXVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45871-0700
Mailing Address - Country:US
Mailing Address - Phone:480-392-6418
Mailing Address - Fax:
Practice Address - Street 1:19100 E SHELBY RD
Practice Address - Street 2:
Practice Address - City:NEW KNOXVILLE
Practice Address - State:OH
Practice Address - Zip Code:45871-9531
Practice Address - Country:US
Practice Address - Phone:480-392-6418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW199581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical