Provider Demographics
NPI:1740618081
Name:LOMELAND, REBECCA ELLEN (LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELLEN
Last Name:LOMELAND
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ELLEN
Other - Last Name:DEMBOSZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 SE 124TH AVE
Mailing Address - Street 2:STE 22
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684
Mailing Address - Country:US
Mailing Address - Phone:360-975-2842
Mailing Address - Fax:360-693-2045
Practice Address - Street 1:108 SE 124TH AVE
Practice Address - Street 2:STE 22
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684
Practice Address - Country:US
Practice Address - Phone:360-975-2842
Practice Address - Fax:360-693-7784
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60663953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health