Provider Demographics
NPI:1366749483
Name:RONDEAU, REBECCA (LICSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:RONDEAU
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 DANIEL WEBSTER HWY UNIT 1636
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-8022
Mailing Address - Country:US
Mailing Address - Phone:617-702-0722
Mailing Address - Fax:
Practice Address - Street 1:971 IRIS ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-2718
Practice Address - Country:US
Practice Address - Phone:617-702-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138591041C0700X
MELC206651041C0700X
DCLC00000021041C0700X
NH21451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical