Provider Demographics
NPI:1114360732
Name:CRAIG, REBEL BT (LPCC)
Entity type:Individual
Prefix:
First Name:REBEL
Middle Name:BT
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ELLEN
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:600 F STREET, SUITE 3
Mailing Address - Street 2:#725
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521
Mailing Address - Country:US
Mailing Address - Phone:707-244-1938
Mailing Address - Fax:
Practice Address - Street 1:600 F STREET, SUITE 3
Practice Address - Street 2:#725
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521
Practice Address - Country:US
Practice Address - Phone:707-244-1938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
CALPCC4505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health