Healthcare Provider Details

I. General information

NPI: 1972002566
Provider Name (Legal Business Name): REBEKAH GALE GOEHLER MSW, CTP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 NINE MILE RD
RICHMOND VA
23223-4831
US

IV. Provider business mailing address

13105 SIR SCOTT DR
CHESTER VA
23831-4753
US

V. Phone/Fax

Practice location:
  • Phone: 804-652-3600
  • Fax:
Mailing address:
  • Phone: 804-475-6250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: