Provider Demographics
NPI:1780452151
Name:SPULLER, REBECCA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:SPULLER
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-0062
Mailing Address - Country:US
Mailing Address - Phone:260-348-3565
Mailing Address - Fax:
Practice Address - Street 1:767 WILLAMETTE ST STE 202
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2924
Practice Address - Country:US
Practice Address - Phone:260-222-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL300281041C0700X
IN34011543A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical