Provider Demographics
NPI:1124320635
Name:WELSH, REBECCA BARNS (PHD,MED, LPC)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:BARNS
Last Name:WELSH
Suffix:
Gender:F
Credentials:PHD,MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E BETHANY DR STE B-130
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3801
Mailing Address - Country:US
Mailing Address - Phone:469-631-0369
Mailing Address - Fax:
Practice Address - Street 1:333 E BETHANY DR STE B-130
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3801
Practice Address - Country:US
Practice Address - Phone:469-631-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5928101YP2500X
TX82770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO31229271Medicaid
TX402879701Medicaid