MEDICARE: REBECCA NASEMAN

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	94819	TX

General Provider Information

NPI Number	:	1154257210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA NASEMAN

Provider Business Mailing Address
First Line	:	11734 GRIMALDI ST
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-4514
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11734 GRIMALDI ST
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-4514
Country	:	US
Telephone Number	:	208-220-2633
Fax Number	:

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

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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