Provider Demographics
NPI:1124244512
Name:BADEN, REBECCA S (LPCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BADEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 DANBURY RD NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-6041
Mailing Address - Country:US
Mailing Address - Phone:330-418-1777
Mailing Address - Fax:330-867-0056
Practice Address - Street 1:70 N MILLER RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3702
Practice Address - Country:US
Practice Address - Phone:330-867-0066
Practice Address - Fax:330-867-0056
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0003620101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional