Provider Demographics
NPI:1497596324
Name:WHITE, REBECCA RENEE (LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RENEE
Last Name:WHITE
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:PO BOX 386
Mailing Address - Street 2:
Mailing Address - City:TREYNOR
Mailing Address - State:IA
Mailing Address - Zip Code:51575-0386
Mailing Address - Country:US
Mailing Address - Phone:712-310-1171
Mailing Address - Fax:
Practice Address - Street 1:14 PARK ST
Practice Address - Street 2:
Practice Address - City:TREYNOR
Practice Address - State:IA
Practice Address - Zip Code:51575-7113
Practice Address - Country:US
Practice Address - Phone:712-310-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA126205101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health