Provider Demographics
NPI:1669063640
Name:TROUT, REBECCA (MSPC,LPC,NCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TROUT
Suffix:
Gender:F
Credentials:MSPC,LPC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 MELCROFT RD
Mailing Address - Street 2:
Mailing Address - City:ACME
Mailing Address - State:PA
Mailing Address - Zip Code:15610-1106
Mailing Address - Country:US
Mailing Address - Phone:724-493-0333
Mailing Address - Fax:
Practice Address - Street 1:462 MELCROFT RD
Practice Address - Street 2:
Practice Address - City:ACME
Practice Address - State:PA
Practice Address - Zip Code:15610-1106
Practice Address - Country:US
Practice Address - Phone:724-493-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012832101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional