Healthcare Provider Details

I. General information

NPI: 1164858692
Provider Name (Legal Business Name): REBECCA FELTS MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA SCHEEL MSW

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 10/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 E STROOP RD
DAYTON OH
45429-3245
US

IV. Provider business mailing address

2500 E FOOTHILL BLVD
PASADENA CA
91107-3464
US

V. Phone/Fax

Practice location:
  • Phone: 937-294-6004
  • Fax:
Mailing address:
  • Phone: 626-993-3000
  • Fax: 626-656-4165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1700650
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: