Provider Demographics
NPI:1386065795
Name:GOINES, REBECCA (LPCC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GOINES
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WOODS TRL APT 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2646
Mailing Address - Country:US
Mailing Address - Phone:859-893-7981
Mailing Address - Fax:
Practice Address - Street 1:132 WOODS TRL APT 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2646
Practice Address - Country:US
Practice Address - Phone:859-358-5099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-02
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1501101YM0800X
KY168435101YM0800X
KY127488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health