MEDICARE: MS. REBEKAH RENE SCOTT MA, LPC, CCTP-II

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	101YP2500X	Professional Counselor	6875	ID
2	101YP2500X	Professional Counselor	LPC-6875	ID

General Provider Information

NPI Number	:	1639664600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBEKAH RENE SCOTT MA, LPC, CCTP-II

Provider Business Mailing Address
First Line	:	2214 E. ELM GROVE DR.
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-7006
Country	:	US
Telephone Number	:	208-573-1273
Fax Number	:	208-437-7488

Provider Business Practice Location Address
First Line	:	2214 E. ELM GROVE DR.
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-7006
Country	:	US
Telephone Number	:	208-573-1273
Fax Number	:	208-437-7488

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	10/04/2023

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