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General NPI Number Information
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NPI Number | 1831310937
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Entity Type | Individual
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Provider Name | REBECCA S DERWIN MA LPC
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 04/15/2010
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Provider Practice Location Address
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Address Line | 104 COLLEGE ST
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City | OXFORD
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State | NC
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Zip | 27565-2962
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Country | US
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Telephone | 919-693-2122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1847
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City | OXFORD
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State | NC
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Zip | 27565-1847
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Country | US
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Telephone | 919-693-2122
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1421
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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