Provider Demographics
NPI:1194068346
Name:WHITING, REBECCA (MA, LPC, CSAC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:WHITING
Suffix:
Gender:F
Credentials:MA, LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7280 S 13TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-1831
Mailing Address - Country:US
Mailing Address - Phone:414-671-9784
Mailing Address - Fax:
Practice Address - Street 1:400 W RIVER DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1518
Practice Address - Country:US
Practice Address - Phone:262-334-4340
Practice Address - Fax:262-334-4341
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1725-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional