MEDICARE: REBECA ALCANTARA LAMFT

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	106H00000X	Marriage & Family Therapist	37FA00022800	NJ

General Provider Information

NPI Number	:	1447924006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECA ALCANTARA LAMFT

Provider Business Mailing Address
First Line	:	1508 W 7TH ST
Second Line	:
City	:	PISCATAWAY
State	:	NJ
Zip	:	08854-1604
Country	:	US
Telephone Number	:	908-208-8556
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 PARK ST STE 104
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2988
Country	:	US
Telephone Number	:	917-464-5272
Fax Number	:

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

Provider Enumeration Date	:	08/05/2021
Last Update Date	:	08/05/2021

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Directions to “ REBECA ALCANTARA LAMFT” Practice Location

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