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NPI Code Detail

MEDICARE: REBECCA LUVENIA WINFREY MSW

MEDICARE: REBECCA LUVENIA WINFREY MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLICSW1140208MA

General Provider Information

NPI Number : 1093048696
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LUVENIA WINFREY MSW
Provider Business Mailing Address
First Line : 409 ARMISTICE BLVD
Second Line :
City : PAWTUCKET
State : RI
Zip : 02861-2430
Country : US
Telephone Number : 857-294-6689
Fax Number :
Provider Business Practice Location Address
First Line : 520 DUDLEY ST
Second Line :
City : ROXBURY
State : MA
Zip : 02119-2769
Country : US
Telephone Number : 617-989-9499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2009
Last Update Date : 01/21/2026

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