Provider Demographics
NPI:1912968116
Name:VALCARCE, REBECCA WYCISK (LPC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:WYCISK
Last Name:VALCARCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 S 400 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5649
Mailing Address - Country:US
Mailing Address - Phone:801-299-0621
Mailing Address - Fax:801-294-4752
Practice Address - Street 1:3809 S WEST TEMPLE
Practice Address - Street 2:#1-B
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4467
Practice Address - Country:US
Practice Address - Phone:801-268-4454
Practice Address - Fax:801-268-2176
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1358386004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health