Provider Demographics
NPI:1285179408
Name:WEYMES, REBEKAH BURGESS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:BURGESS
Last Name:WEYMES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:REBEKAH
Other - Middle Name:LYNN
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:24760 LOGANS WOODS DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-2429
Mailing Address - Country:US
Mailing Address - Phone:410-253-2508
Mailing Address - Fax:
Practice Address - Street 1:202 COURSEVALL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-2804
Practice Address - Country:US
Practice Address - Phone:410-758-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22343104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker