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General NPI Number Information
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NPI Number | 1457553018
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Entity Type | Individual
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Provider Name | REBECCA LYNN FUGATE L.C.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 713 GARREN CREEK RD
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City | FAIRVIEW
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State | NC
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Zip | 28730-7610
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Country | US
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Telephone | 828-216-7370
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1579
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City | BLACK MOUNTAIN
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State | NC
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Zip | 28711-1579
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Country | US
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Telephone | 828-216-7370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4575
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License Number State | NC
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