MEDICARE: REBECCA LOUISE ELLIOTT LPCC

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	101Y00000X	Counselor	0490	KY

General Provider Information

NPI Number	:	1548371248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA LOUISE ELLIOTT LPCC

Provider Business Mailing Address
First Line	:	3025 DALE ANN DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40220-2512
Country	:	US
Telephone Number	:	502-749-1520
Fax Number	:

Provider Business Practice Location Address
First Line	:	3906 DUPONT SQ S STE A
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4647
Country	:	US
Telephone Number	:	502-896-1850
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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