Healthcare Provider Details

I. General information

NPI: 1699885046
Provider Name (Legal Business Name): REBECCA HYDE SITNIK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

458 MADISON RD
ORANGE VA
22960-1085
US

IV. Provider business mailing address

PO BOX 1568
CULPEPER VA
22701-6568
US

V. Phone/Fax

Practice location:
  • Phone: 540-672-2718
  • Fax: 540-672-1196
Mailing address:
  • Phone: 540-825-3100
  • Fax: 540-825-6245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003753
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: