MEDICARE: REBEKAH GILLIS SMITH

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

General Provider Information

NPI Number	:	1689561482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH GILLIS SMITH

Provider Business Mailing Address
First Line	:	1610 S 14TH ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-5758
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 S 14TH ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-5758
Country	:	US
Telephone Number	:	479-925-6020
Fax Number	:

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

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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Directions to “ REBEKAH GILLIS SMITH ” Practice Location

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