Provider Demographics
NPI:1720692486
Name:SEBASTIAN, REBECCA CLAIRE CARLSON (LCSW MPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLAIRE CARLSON
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:LCSW MPH
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CLAIRE
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 23RD AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3133
Mailing Address - Country:US
Mailing Address - Phone:865-765-0841
Mailing Address - Fax:
Practice Address - Street 1:1601 23RD AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3133
Practice Address - Country:US
Practice Address - Phone:615-378-7120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1076591041C0700X
TN88081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical