MEDICARE: REBECCA LYNN KIRKLAND LMSW

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	1041C0700X	Clinical Social Worker	17133	SC

General Provider Information

NPI Number	:	1194688382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LYNN KIRKLAND LMSW

Provider Business Mailing Address
First Line	:	2170 N LAKE DR APT 1338
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-8120
Country	:	US
Telephone Number	:	888-500-2067
Fax Number	:	617-649-8520

Provider Business Practice Location Address
First Line	:	600 W PEACHTREE ST NW STE 44
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-3607
Country	:	US
Telephone Number	:	888-500-2067
Fax Number	:	617-649-8520

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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