Healthcare Provider Details

I. General information

NPI: 1124090733
Provider Name (Legal Business Name): REBECCA WOLFE UPPERCUE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CARLISLE ST SUITE 108
GETTYSBURG PA
17325-1823
US

IV. Provider business mailing address

18 CARLISLE ST SUITE 108
GETTYSBURG PA
17325-1823
US

V. Phone/Fax

Practice location:
  • Phone: 717-420-5395
  • Fax: 717-724-5432
Mailing address:
  • Phone: 717-420-5395
  • Fax: 717-724-5432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018295
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: