Healthcare Provider Details
I. General information
NPI: 1477003499
Provider Name (Legal Business Name): REBECCA BISWAS YORK LAC, LMSW, MSW U/S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/13/2016
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
204 E CHOCTAW AVE
SALLISAW OK
74955-4604
US
IV. Provider business mailing address
103189 S 4720 RD
MULDROW OK
74948-6298
US
V. Phone/Fax
- Phone: 918-790-2292
- Fax:
- Phone: 503-349-4391
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 20117 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 095 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: