Healthcare Provider Details

I. General information

NPI: 1225370026
Provider Name (Legal Business Name): REBECCA LYNN SEMSROTT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 08/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13160 CR 3610
ST. JAMES MO
65559-0189
US

IV. Provider business mailing address

PO BOX 189
SAINT JAMES MO
65559-0189
US

V. Phone/Fax

Practice location:
  • Phone: 573-899-7153
  • Fax: 573-265-0156
Mailing address:
  • Phone: 573-899-7153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2013005535
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: