Provider Demographics
NPI:1356121883
Name:CHRISTIAN, REBECCA (LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2742 NEVADA RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-3255
Mailing Address - Country:US
Mailing Address - Phone:607-768-6620
Mailing Address - Fax:
Practice Address - Street 1:2742 NEVADA RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-3255
Practice Address - Country:US
Practice Address - Phone:607-768-6620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20941101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health