Provider Demographics
NPI:1376387258
Name:MASSEY, REBECA JENAE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:REBECA
Middle Name:JENAE
Last Name:MASSEY
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 1:15314 BLACK FALLS LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1290
Mailing Address - Country:US
Mailing Address - Phone:512-695-8337
Mailing Address - Fax:
Practice Address - Street 1:15314 BLACK FALLS LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-1290
Practice Address - Country:US
Practice Address - Phone:512-695-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX683451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical