Provider Demographics
NPI:1750797841
Name:RADCLIFFE, REBECCA HARRISON (MA, LCPC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:HARRISON
Last Name:RADCLIFFE
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:KARR
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:938 WINTER RUN RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1854
Mailing Address - Country:US
Mailing Address - Phone:610-937-2207
Mailing Address - Fax:443-451-8132
Practice Address - Street 1:938 WINTER RUN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-1854
Practice Address - Country:US
Practice Address - Phone:610-937-2207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MDLC5953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty