=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316800410
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | REBECCA JAMES LPC, NCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 189 N BRUNSWICK ST
-----------------------------------------------------
City | JESUP
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31546-4377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-530-8889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7074 FLOYD JAMES RD
-----------------------------------------------------
City | MANOR
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31550-2508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC016173
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------