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General NPI Number Information
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NPI Number | 1497483796
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Entity Type | Individual
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Provider Name | REBECCA ANN LEDERMAN LCPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 08/13/2022
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 617 FRANKLIN AVE STE 19
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City | BERLIN
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State | MD
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Zip | 21811-1358
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Country | US
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Telephone | 443-252-3369
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Fax |
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Provider Business Mailing Address
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Address Line | 100 PINEHURST RD
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City | BERLIN
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State | MD
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Zip | 21811-1620
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Country | US
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Telephone | 443-252-3369
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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 | LCPC15450
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License Number State | MD
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