Healthcare Provider Details

I. General information

NPI: 1194023556
Provider Name (Legal Business Name): REBECCA JOY DUEBECK CMHC, ASUDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N FREEDOM BLVD
PROVO UT
84601-1677
US

IV. Provider business mailing address

151 S UNIVERSITY AVE
PROVO UT
84601-4427
US

V. Phone/Fax

Practice location:
  • Phone: 801-373-4760
  • Fax: 801-373-0639
Mailing address:
  • Phone: 801-851-7127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8562301-6004
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number8562301-6006
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: