Provider Demographics
NPI:1881358513
Name:MCCRACKEN, REBECCA LYNN (LPCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:LPCC
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 6209
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42702-6209
Mailing Address - Country:US
Mailing Address - Phone:800-545-9031
Mailing Address - Fax:859-757-4501
Practice Address - Street 1:201 PETERSON DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9370
Practice Address - Country:US
Practice Address - Phone:800-545-9031
Practice Address - Fax:859-757-4501
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional