MEDICARE: REBECCA ANN PIERCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1053772764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ANN PIERCE

Provider Business Mailing Address
First Line	:	710 N 24TH ST
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-3026
Country	:	US
Telephone Number	:	267-551-0092
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 SLITTING MILL RD
Second Line	:
City	:	GLEN MILLS
State	:	PA
Zip	:	19342-1617
Country	:	US
Telephone Number	:	618-616-9330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2016
Last Update Date	:	12/21/2022

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