MEDICARE: REBEKAH KANEFSKY LPC LLC

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
1	101YP2500X	Professional Counselor	002878	CT

General Provider Information

NPI Number	:	1871941146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBEKAH KANEFSKY LPC LLC

Provider Business Mailing Address
First Line	:	59 ROCK SPRING RD
Second Line	:	UNIT 32
City	:	STAMFORD
State	:	CT
Zip	:	06906-1934
Country	:	US
Telephone Number	:	646-334-2420
Fax Number	:

Provider Business Practice Location Address
First Line	:	59 ROCK SPRING RD
Second Line	:	UNIT 32
City	:	STAMFORD
State	:	CT
Zip	:	06906-1934
Country	:	US
Telephone Number	:	646-334-2420
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	REBEKAH KANEFSKY
Credential	:	LPC
Telephone Number	:	646-334-2420

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	05/27/2016

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