Healthcare Provider Details

I. General information

NPI: 1346790649
Provider Name (Legal Business Name): REBEKAH ALEXANDER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 HIGHWAY 62 412
SALEM AR
72576
US

IV. Provider business mailing address

PO BOX 176
CHEROKEE VILLAGE AR
72525-0176
US

V. Phone/Fax

Practice location:
  • Phone: 870-384-1744
  • Fax: 870-384-1743
Mailing address:
  • Phone: 870-856-3337
  • Fax: 870-856-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number9688-M
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: