Provider Demographics
NPI:1154138618
Name:VENTRESCA, REBECCA (MA, LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:VENTRESCA
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 HARPER LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-2762
Mailing Address - Country:US
Mailing Address - Phone:508-560-3998
Mailing Address - Fax:
Practice Address - Street 1:61 HARPER LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2762
Practice Address - Country:US
Practice Address - Phone:508-560-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALHMC12613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health