Provider Demographics
NPI:1215781588
Name:LEDFORD, REBECCA (MSW, LSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 COUNTY ROAD 514
Mailing Address - Street 2:
Mailing Address - City:IGNACIO
Mailing Address - State:CO
Mailing Address - Zip Code:81137-9150
Mailing Address - Country:US
Mailing Address - Phone:970-749-8352
Mailing Address - Fax:
Practice Address - Street 1:3441 COUNTY ROAD 514
Practice Address - Street 2:
Practice Address - City:IGNACIO
Practice Address - State:CO
Practice Address - Zip Code:81137-9150
Practice Address - Country:US
Practice Address - Phone:970-749-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLSW.0009925339104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker