Healthcare Provider Details
I. General information
NPI: 1699178863
Provider Name (Legal Business Name): REBECCA A ASHWORTH-RHEIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/02/2014
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
180 S 3RD ST STE 104
BELLEVILLE IL
62220-1952
US
IV. Provider business mailing address
180 S 3RD ST STE 104
BELLEVILLE IL
62220-1952
US
V. Phone/Fax
- Phone: 618-222-4701
- Fax: 618-222-4754
- Phone: 618-222-4701
- Fax: 618-222-4754
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 149020026 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: