Provider Demographics
NPI:1265934111
Name:REBECCA ELLINGER PSY. D., P. A.
Entity type:Organization
Organization Name:REBECCA ELLINGER PSY. D., P. A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-498-5300
Mailing Address - Street 1:1067 CIRCLE DR APT A
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3044
Mailing Address - Country:US
Mailing Address - Phone:561-498-5300
Mailing Address - Fax:561-498-5301
Practice Address - Street 1:1067 CIRCLE DR APT A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3044
Practice Address - Country:US
Practice Address - Phone:561-498-5300
Practice Address - Fax:561-498-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty