Healthcare Provider Details

I. General information

NPI: 1891122883
Provider Name (Legal Business Name): REBECCA C HUNKE LCMHC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA C GEROULD ADC

II. Dates (important events)

Enumeration Date: 10/04/2013
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 VT ROUTE 149
WEST PAWLET VT
05775-9798
US

IV. Provider business mailing address

33 BLINN ST
WHITEHALL NY
12887-1602
US

V. Phone/Fax

Practice location:
  • Phone: 802-645-0580
  • Fax:
Mailing address:
  • Phone: 518-791-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000606
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number151.0126818
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number068.0107640
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: