Healthcare Provider Details

I. General information

NPI: 1336819721
Provider Name (Legal Business Name): REBECCA LYNN PRIEGEL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S LINCOLNWAY
NORTH AURORA IL
60542-1663
US

IV. Provider business mailing address

1018 ELM ST
ST CHARLES IL
60174-4127
US

V. Phone/Fax

Practice location:
  • Phone: 630-801-1669
  • Fax:
Mailing address:
  • Phone: 630-229-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: