Provider Demographics
NPI:1700245081
Name:WARRINER, REBECCA (LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WARRINER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 PRESERVATION WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7879
Mailing Address - Country:US
Mailing Address - Phone:859-957-6067
Mailing Address - Fax:
Practice Address - Street 1:2390 PRESERVATION WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-7879
Practice Address - Country:US
Practice Address - Phone:859-957-6067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY241002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100520400Medicaid