MEDICARE: REBECCA WHITSON LPC

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	P1906072	AR

General Provider Information

NPI Number	:	1174184733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA WHITSON LPC

Provider Business Mailing Address
First Line	:	3404 S 28TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-6906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2917 OLD GREENWOOD RD STE 3
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4559
Country	:	US
Telephone Number	:	479-459-2166
Fax Number	:

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

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	06/25/2019

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Directions to “ REBECCA WHITSON LPC” Practice Location

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