MEDICARE: MS. REBECCA LEE EKLUND LMHC, CASAC

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	013108	NY

General Provider Information

NPI Number	:	1699519710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA LEE EKLUND LMHC, CASAC

Provider Business Mailing Address
First Line	:	485 SPRING DR
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-6008
Country	:	US
Telephone Number	:	631-618-7448
Fax Number	:

Provider Business Practice Location Address
First Line	:	485 SPRING DR
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-6008
Country	:	US
Telephone Number	:	631-618-7448
Fax Number	:

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

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/24/2024

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