Provider Demographics
NPI:1396914537
Name:GIRGIS, REBECCA LYNN (LPC, RPT&S)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:GIRGIS
Suffix:
Gender:F
Credentials:LPC, RPT&S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165
Mailing Address - Country:US
Mailing Address - Phone:706-292-0587
Mailing Address - Fax:706-292-9437
Practice Address - Street 1:104 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3128
Practice Address - Country:US
Practice Address - Phone:706-235-6990
Practice Address - Fax:706-235-4985
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional