Provider Demographics
NPI:1265609259
Name:SKEELE, REBECCA EMMA (MA LPCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:EMMA
Last Name:SKEELE
Suffix:
Gender:F
Credentials:MA LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 PLAZA BALENTINE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2739
Mailing Address - Country:US
Mailing Address - Phone:505-984-1739
Mailing Address - Fax:505-820-7009
Practice Address - Street 1:339 PLAZA BALENTINE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2739
Practice Address - Country:US
Practice Address - Phone:505-984-1739
Practice Address - Fax:505-820-7009
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0095231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health