Provider Demographics
NPI:1770261646
Name:RAIFORD, REBEKAH JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:JEAN
Last Name:RAIFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7517 EUCLID DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-3093
Mailing Address - Country:US
Mailing Address - Phone:214-215-8779
Mailing Address - Fax:
Practice Address - Street 1:930 W RALPH HALL PKWY STE 114
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6664
Practice Address - Country:US
Practice Address - Phone:214-646-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX585321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical