Provider Demographics
NPI:1346455623
Name:WALTERS, REBECCA (LCAT LMHC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:LCAT LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 DUBOIS RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3820
Mailing Address - Country:US
Mailing Address - Phone:845-255-7502
Mailing Address - Fax:
Practice Address - Street 1:68 DUBOIS RD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3820
Practice Address - Country:US
Practice Address - Phone:845-255-7502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health