Healthcare Provider Details

I. General information

NPI: 1407469851
Provider Name (Legal Business Name): REBECCA SALMONS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 12/23/2025
Certification Date: 02/06/2024
Deactivation Date: 12/10/2025
Reactivation Date: 12/23/2025

III. Provider practice location address

1071 TONG HOLLOW RD
BAINBRIDGE OH
45612-1500
US

IV. Provider business mailing address

PO BOX 188
CHILLICOTHEE OH
45601-0188
US

V. Phone/Fax

Practice location:
  • Phone: 740-649-3094
  • Fax:
Mailing address:
  • Phone: 740-773-4366
  • Fax: 740-773-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: