Provider Demographics
NPI:1811714090
Name:STANDLEY, REBECCA DANIELLE (LMSW, BCN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:DANIELLE
Last Name:STANDLEY
Suffix:
Gender:F
Credentials:LMSW, BCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 S MILAM ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-2050
Mailing Address - Country:US
Mailing Address - Phone:806-410-0698
Mailing Address - Fax:
Practice Address - Street 1:1907 S MILAM ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-2050
Practice Address - Country:US
Practice Address - Phone:806-410-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker